Fam Pract Manag. 2012 Mar-Apr;19(2):8.

We are our own worst enemy

The article “The State of Family Medicine” [January/February 2012] contained interesting information, including a quote by Robert Phillips Jr., MD, MSPH, who stated that the value of family medicine is diminished as its scope of practice shrinks.

I would argue that the biggest reason family medicine is undervalued is the proliferation of nurse practitioners. On the one hand, we as a group of family medicine doctors are touting our unique qualifications to provide high-quality, comprehensive health care. On the other hand, we are telling our patients that seeing the nurse practitioner is an acceptable (and implicitly an equivalent) option.

It is no wonder that patients view these physician extenders as equivalent to doctors and often mistakenly refer to them as doctors, especially those who do business in their own facilities without a doctor on site. As Walt Kelly famously stated through his creation Pogo, “We have met the enemy and he is us.”


Send your comments to fpmedit@aafp.org. Submission of a letter will be construed as granting AAFP permission to publish the letter in any of its publications in any form. We cannot respond to all letters we receive. Those chosen for publication will be edited for length and style.


Copyright © 2012 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact fpmserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Mar-Apr 2018

Access the latest issue
of FPM journal

Read the Issue

FPM E-Newsletter

Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights."

Sign Up Now


Helping Your Adolescent and Young Adult Patients Get the Preventive Care and Services They Need

The Adolescent Health Consortium Project has clarified clinical preventive service recommendations for adolescents and young adults.

Making Sense of MACRA: Navigate Changes to the Quality Payment Program in 2018

Here's how to succeed in the four performance categories of the Merit-based Incentive Payment System.