Family medicine as counterculture.
1989; National Institutes of Health; Volume: 21; Issue: 2 Linguagem: Inglês
Autores Tópico(s)
Child and Adolescent Health
ResumoI want to speak about the future of family medicine as counterculture. Some of us recoil at the use of the language of “reform” and “revolution” to describe our discipline. These are the semantics of violence, and they project an image that we do not feel. We are benevolent, wellintentioned, “humble country doctors” who only want to restore some balance to medicine. We do not want to destroy anything or take anything away from anybody; we just want a place in the sun for ourselves and our residents and students. We are not radicals who wish to turn the world upside down. Indeed, I have sometimes thought that our cumulative effect on the body politic of medicine has been conservative more than liberal or radical. In many ways, by our success, we have taken the heat off the medical profession from the public; therefore, the status quo is being preserved. That is conservative. More radical solutions to perceived problems will not be imposed as long as the public thinks that something is being done. Short-term effects are not the best criteria, however, for determining the social effects of a movement. Neither are the stated objectives of most of the people who participate in it. There are a number of perspectives from which one can analyze the renascence of family practice in the sixth and seventh decades of this century. Quantitatively, it is an unprecedented phenomenon. The numbers of departments, programs, and residents are well known to you. The magnitude of this achievement required the convergence of social, political, economic, and professional forces, over most of which we had (and have) very little control. Many different institutions, organizations, groups, and individuals with differing agendas and expectations have invested heavily in the family practice movement. No one can be given credit for our success. The time was right, the idea was right, and from the perspective of one who has participated almost from the beginning, there has been an aura of serendipity about it all. Most of us have simply responded to opportunities that just seemed to be there. There is a sense of having participated in something that is a great deal bigger than oneself and one’s ideas. Qualitatively, there is a precedent for family practice in pediatrics. That specialty preceded us by 35 years, and many of the forces that created pediatrics are similar. Rosemary Stevens has chronicled the development of medical and surgical specialties in the United States from the late 19th century through the
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