Commentators Say Family Practice Achieves Much, Faces Challenges

WASHINGTON -- Family practice has delivered on its promise to reverse the decline of general practice and care for people with diverse health problems in all areas of the country, but the specialty faces significant challenges. That’s the assessment of Larry A. Green, M.D., and George E. Fryer Jr., Ph.D., in a special theme article in the August issue of Academic Medicine. Green is director and Fryer is an analyst at the Robert Graham Center: Policy Studies in Family Practice and Primary Care.

“Many important health care problems remain unsolved, in part because of poor role delineation for family physicians, poor differentiation of family practice from other fields, and insufficient changes in the cultural and political environment,” the authors write.

The authors point out that the first family practice residencies were launched as the specialty was established in 1969, and by developing innovations in community-based teaching, family practice teachers have made a significant impact. In addition, they point out that of the civilian, non-institutionalized U.S. population surveyed in 1996 who named a usual source of care, 62 percent identified a family physician. Furthermore, the authors say some of the public’s reliance on family practice stems from the geographic distribution of family physicians; their distribution more closely parallels that of the general populace than any other specialty. In 2000, 19.7 percent of the population lived outside metropolitan statistical areas and 25.7 percent of the offices of family physicians or general practitioners were located in such areas, compared to 11.9 percent of other office-based physicians.

The authors identify four main areas for improvement:

While detailing the challenges family medicine faces, the authors are optimistic about the future of family practice. “This is possibly the first time in history that the ambitious aspirations of family practice are actually achievable,” conclude the authors.