The family and family medicine: should this marriage be saved?

Although there have been many noteworthy attempts to integrate a family focus into family medicine, there is little evidence that this integration has occurred in either residency education or community practice. When the specialty was founded, a family emphasis may have been politically useful as a way to differentiate the new family physician from the old general practitioner. Now, however, it is unclear what specific family-related material should be taught or who should teach it since few family practice faculty are trained in understanding families. If a practicing family physician actually wants to see a family, practical problems concerning time, space, and money arise. Furthermore, the medicolegal system is structured to protect the confidential relationship between one patient and one physician. Other obstacles to the integration include the difficult epistemological shift required to apply systems theory, the current chaos in the family field, and family medicine's need to gain professional stature by being proficient in traditional medicine. It may be time for the family and family medicine to reconsider their well-intended but ill-advised relationship.