Howard Brody is a very bright man. In this editorial, he reminds us that many of the techniques we so proudly master .. as we BATHE our patients (see below) … may in fact be as culturally insensitive as our less thoughful colleagues.
As the match is over, all-of-a-sudden it's recruitment season already. Not at the residency level (yet) but in the medical school. The 3rd-year students are all doing their best to make a decision about what they want to be when they grow up, and our colleagues in other specialties are pontificating the "don't go into family medicine" speech rather loudly these days. Of course the most vocal are from obstetrics and pediatrics. I think that the general internists are starting to undersatnd and appreciate us a bit. It's hard NOT to be offended by these stuffed-shirts … telling my advisees that the are "too smart" to go into family medicine. It hasn't been so bad for several years. Not sure why the resurgence.
The University of Washington has a good FAQ on family medicine. I like their discussion of Medicine-Pediatrics:
Combined programs do not require as much time in outpatient training and their residents do not care for whole families over a three-year period. They also do not provide, to the same extent, many of the elements offered by family practice training, such as community medicine, preventive medicine, techniques for home visiting, patient education and training in the understanding of family systems.
A follow-up study of two combined internal medicine-pediatrics residencies revealed that only about one half of the graduates continued with the primary care of children and adults; the rest pursued just internal medicine, pediatrics, or a subspecialty.