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Fam Pract Manag. 2006;13(2):16-22

In response to Dr. William Hueston's editorial “Rekindling the Fire of Family Medicine” [January 2006], I'm afraid the fire cannot be rekindled. It is too much to ask medical students to value a nice relationship with their patients more than the satisfactions of high-tech, subspecialty care. In fact, the proposition is a bit of a con job. How can today's doctors have the kind of relationships that family physicians of my era valued and enjoyed so much when they are not there to deliver the babies, insert the pacemaker for the acute MI patient, fix the fracture in the ER, do the follow-up and final care for the patient with cancer, remove the inflamed appendix, assist the orthopedist when he pins a hip, answer the phone during the wee hours of the night, and generally be available for all things at all times? The family physicians who are still in a position to do some of these things have the relationships we prize, but a full scope of practice is not always possible because of the increasing availability of specialists, subspecialists, hospitalists and midlevel practitioners.

We must realize that we are witnessing the final years of family medicine. The only bright point I see is that we are probably not much better at predicting the future of American medicine than our predecessors have been.

I read with interest Dr. Hueston's editorial regarding the status of happiness among family physicians. I understand his concerns and have witnessed some of them among my colleagues. However, I am very happy in my chosen career as a family physician and am proud to be a member of what I consider the most valuable medical specialty in our great nation. True family medicine embraces continuity and attracts like-minded, relationship-seeking patients. Many of my patients have been with me through multiple practice settings, and they are the main reasons I enjoy going to the hospital and office every day.

A thought on Dr. Hueston's commentary: Patients don't value continuity and their physician's independence as much as their own convenience and cost. Those who do tend to be more emotionally needy and not as well insured.

As a third-year resident, I am very encouraged by Dr. Hueston's commentary. My decision to go into family medicine was based on the values and ideals Dr. Hueston mentioned. Nevertheless, going into family medicine was a hard decision to make because the “better life” is in the high-tech specialties. I'll admit I have grown somewhat cynical of my profession because of the disheartening statements and actions of some of my colleagues. It is discouraging to hear the frustrations and opinions of veteran family doctors, and it makes me concerned about the future. It was a pleasure to read an editorial by a seasoned physician with the same desires to improve this atmosphere and possibly rekindle the fire for family medicine in me and many others like me.


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