In the 1940s, general practitioners confronted the "mad rush toward specialization"--that's how first AAGP President Paul Davis, MD, of Akron, OH, described the situation.
During World War II, GPs were assigned to treat casualties on the front lines, while specialists worked well out of the range of fire. Graduating medical students received deferments to enter specialty residencies, but GPs had no residencies and therefore no deferments.
After the war, general practitioners came home expecting to return to their broad scope of practice. But the American College of Surgeons, then the accrediting agency for hospitals, was barring general practitioners from performing surgeries, including ones they'd done before the war.
Stanley R. Truman, MD, of Oakland, CA, AAGP president in 1950-51, opened The History of the Founding of the American Academy of General Practice with this statement: "The general practitioner was at the bottom of the totem pole in 1946. Many doctors and educators were sure that general practice was on the way out."
At the first meeting of the AMA section on general practice, held during the 1946 AMA meeting in San Francisco, general practitioners shared their discouragement and decided to create their own medical society. They elected section officers and, after the section meeting, elected the same people as officers pro-tem for the society to be established the next year. The officers publicized the 1947 meeting and decided to recommend the name American Academy of General Practice.
At 8:25 p.m. June 10, 1947, in Atlantic City, NJ, about 200 general practitioners began the society's organizational meeting in the Claridge Hotel's Solarium--rented by the AMA for the GPs' gathering. The participants had seen representatives of large states control other societies, and they voted instead to have a governing body with two delegates from each state, as provided in the Bylaws the officers pro-tem proposed. Dr. Truman said in his history, "We wanted to avoid the `government by old men' that we thought many of the other medical associations had fallen into."
Physicians at the 1947 meeting unanimously adopted the Bylaws and Constitution, elected their officers, and began selecting delegates in state caucuses. By the end of the AMA meeting, 220 GPs had applied for membership for the fee of $25.
The AAGP was born.
From Atlantic City to home
One of the physicians at AAGP's organizational meeting was Henry L. Harrell Sr., MD, of Ocala, FL, later a Florida AGP president. He went to Atlantic City to participate in AMA's general practice section. "We decided to make a more active organization and try to give some opposition to the specialists because they were taking over medicine from us," he says.
Explaining why specialists were becoming more influential and had more time for organizational activities, Dr. Harrell says, "The specialists weren't quite as busy in their own practices that they had to stay put so tightly."
He and two other Florida general practitioners at the meeting returned home, talked with their colleagues, and convinced them to form the Florida AGP in 1948. The FAGP held its first meeting in conjunction with the meeting of the Florida Medical Association. The next year, about 100 GPs came to Ocala for the FAGP's first three-day educational conference, which Dr. Harrell organized.
Now 88, Dr. Harrell speaks of his career with pride. He delivered more than 3,000 babies, attended AAGP Congresses as a delegate, and served on hospital privileges committees to keep GPs from being voted out of the practice of surgery.
He and other FAGP members shared their love of their work with medical students and residents. Students took three-week preceptorships at Dr. Harrell's office, and he paid residents to assist him. "That's how we imbued some of them with the idea of being general practitioners," says Dr. Harrell. "It worked out."
By 1949, the AAGP had about 10,000 members. Across the country, AAGP chapters took root and spread their enthusiasm for general practice to the next generation.
Consolidation
Dr. Truman served as AAGP's secretary during its first months, handling its correspondence and writing its newsletter from his office. By the fall of 1947, the AAGP hired Mac Cahal, JD, as executive secretary. His letter to Dr. Truman about the opportunity to serve as the AAGP executive secretary was exuberant "I am fairly popping with ideas. ... We can start out, I believe, with a small staff. ... Has any thought been given to establishing headquarters in some city other than Chicago? ... What are your tentative plans for a journal? I visualize a top-notch scientific publication."
Mr. Cahal, now of Prairie Village, KS, was the American College of Radiology's executive secretary and worked part-time for both organizations from ACR's Chicago office until March 1948. As the Academy's CEO until 1971, he established the AAGP office in Kansas City, MO, in 1948; handled the society's incorporation; coordinated its meetings; oversaw the fund drive for the 1956-73 headquarters building, and helped the organization become the AAFP.