What opportunities have we missed, and what bad deals have we made?
In addition to its many accomplishments, family medicine has inevitably made some choices that have not worked out as well. Respectful consideration of where we may have done so can help inform future decision making. This paper suggests some decisions that in retrospect appear to be bad deals, good deals gone bad, or missed opportunities. Bad deals include the limiting effects of our specialty's name and of our go-it-alone philosophy. Good deals gone bad include our affinity for a permanent counterculture role, our persistent belief that big is better, and limited evolution of our residency family practice centers. We have missed opportunities to lead development of a new model of patient-responsive health care, to change the system of payment for care, to maximize the strength of our discipline by links between university and community family physicians, and to build a powerful program of family medicine research.
Magill
M K
MK
Department of Family and Preventive Medicine, University of Utah, Salt Lake City 84132, USA. mmagill@dfpm.utah.edu
Kane
W J
WJ
D005194:Family Practice / Q000458:organization & administration / Q000639:trends*; D018166:Health Care Reform; D006801:Humans; D015279:Organizational Culture; D009936:Organizational Innovation; D012106:Research; D013038:Specialization