Am Fam Physician. 2000;61(3):630
This feature is part of a year-long series of excerpts and special commentaries celebrating AFP's 50th year of publication. Excerpts from the two 1950 volumes of GP, AFP's predecessor, appear along with highlights of 50 years of family medicine.
This piece, from “What Others Are Saying,” was published in the August 1950 issue of GP.
The General Practitioner—Why and How
Why are fewer graduates of our medical schools becoming general practitioners? Why is there what appears to be a marked lack of interest in the most challenging field of medicine? Why is there such disinterest in the one medical career that offers the physician an opportunity such as comes to few men, to assume roles of high public esteem while rendering devoted service to man and medicine?
Some who have attempted to answer these questions contend that the medical student has been exposed to so many specialists during his undergraduate and intern days, that he has developed “specialitis.” As a remedy, it has been suggested that more general practitioners be added to the teaching staffs of our medical schools to “neutralize” the preponderance of specialty men. Several schools are testing the plan, but to date very few have well-integrated departments of general practice.
Others have hoped to find the answer by establishing selective general practice residencies in hospitals so that the doctor will become better trained and more capable of handling the myriad of diseases and conditions he is called upon to treat. Hospitals pioneering in this movement warrant the continued and grateful thanks of the profession. Their overtures to the family doctor will help considerably in stimulating medical students to become general practitioners.
While there are many social and economic reasons that medical graduates by-pass general practice, almost everyone neglects to mention one of the fundamental considerations of the young man entering practice—his relationship with a hospital as it affects his ability to practice good medicine and to keep his patients. The time has come for an airing.
When all hospitals welcome the general practitioner as a member of the staff with hospital privileges based on his competence to perform procedures indicated by his experience and training, only then will the intern accept the opportunities and advantages of serving the public as a family doctor. There should be no limitations placed on the work he can do within the scope of his qualifications and ability. The general practitioner should be allowed a representative voice in the affairs of the professional staff. His application for privileges in a specialty section should be judged on individual merit rather than on requirements duplicating those of specialty boards.
Sir William Osler went to the heart of the problem when he wrote, “A well-trained, sensible family doctor is one of the most valuable assets in a community.” Let us be truthful. An intelligent readjustment of the general practitioner's place in the hospital will do much to remove the current apathy toward general practice among young medical men. It may mean more family doctors for Wisconsin communities.—Donald C. Ausman, M.D., Wisconsin Medical Journal, April 1950.