You may remember your family's general practitioner from years past. But in the United States, the medical field that was once known as general practice is now called family medicine and a doctor who practices it is a family physician. General practitioners still exist in the U.S. but their numbers are few, according to reports by the American Board of Family Medicine. In addition, there are general practitioners in the United Kingdom and other countries. Today' s family physicians are expected to specialize in treating patients as members of a family rather than as isolated individuals the way some originators of the family practice movement portrayed other specialists as doing.
History
"The History of Family Medicine," a report prepared by Steven Dennis, M.D., states that in the early 1800s, general practitioners made house calls, delivered babies and performed surgery. These days, unless, you live very far away from modern society, you'll only encounter doctors like this in historical books, television programs or movies.
"History of the Specialty," by now-deceased Nicholas J. Pisacano, M.D., recounts that by "1964, the percentage of [medical school] graduates going into General Practice fell to 19%, down from 47% in 1900 and [was] continuously diminishing."
Significance
The January 1997 issue of "FP Report" details how, "as early as 1941," a battle began to be waged inside the medical community between those who wanted to elevate general practice into a specialty and those who did not. Members of the general public--like you and me--probably didn't notice that there was even an issue.
However, the problem was that many specialized fields of medicine were being created but general practitioners weren't considered specialists. On the one hand, they didn't have to remain in school as long as specialists; on the the other, they were accorded less professional respect than specialists.
Purpose
Certain general practitioners sought to create a certifying board for a specialty in family practice. As a result, in February 1969, "The Liaison Committee for Specialty Boards approved the application for the American Board of Family Practice." In this way, family practice became the specialty you may be familiar with.
Effects
After the change, says "The History of Family Medicine," new family physician students could no longer be licensed after completing one year of postgraduate training as interns the way general practitioners formerly could. Instead, students had to remain in school for two or three more years. Soon, the number of general practitioners who switched over to being family practitioners grew.
But few medical students wanted to enter family medicine because they could make more money in other specialties that required the same number of years in school as becoming a family physician required. Still, by the early 1980s family practice was the third largest U.S. specialty.
Name Change
The January/February 2005 issue of "Family Medicine Updates" reports that In 2004, the American Board of Family Practice was renamed the American Board of Family Medicine. And doctors who typically treat lay people like you and me went from being "family practitioners" to "family physicians."
Requirements
Currently, U.S. general practitioners can update their certification through the American Board of General Practice. Without obtaining certification in this way, a general practitioner must return to school to become a certified family physician.
In addition, the American Specialty Boards, another certifying agency, requires all specialists to demonstrate competency in six areas in order to be certified. These areas are Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, Systems-Based Practice and Practice-Based Learning and Improvement.
If you're wondering if your family physician is up to date, ask to see a document confirming certification.
References
- The American Board of Family Medicine: History of the Speciality
- The History of Family Medicine
- AAFP: General Practice Evolves into Family Practice; by AAFP News Department,, January 1997
- American Board of General Practice: Welcome to the Board
- American Board of Medical Specialties: MOC Competencies and Criteria
- Family Medicine Updates: From the American Board of Family Medicine; January/February 2005
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