The domain of family practice: scope, role, and function

The family physician is the physician generalist who takes professional responsibility for the comprehensive care of unselected patients with undifferentiated problems and who is committed to the person regardless of age, gender, illness, or organ system. The clinical specialty of family practice is patient centered, evidence based,family focused, and problem oriented. Family physicians acquire and maintain a broad array of competencies that depend on the needs of the patients and communities they serve. The scope of their practice is not defined by diagnoses or procedures but by human needs. Family physicians do not treat diseases; they take care of people. Nodal points in the family life cycle, such as birth, serious illness, and the end of life, deserve special attention. Family physicians are expert at managing common complaints, recognizing important diseases, uncovering hidden conditions, and managing most acute and chronic illnesses. They emphasize health promotion and disease prevention. Their knowledge, skills, and attitudes target community practice, current science, and continuous quality improvement. Family practice has a distinct clinical approach that requires special skills to identify concerns, focus issues, negotiate plans, and help solve problems. The recognition, integration, and prioritization of multiple concerns and the synthesis of solutions are critical clinical competencies. The variety of human needs require targeting the clinical process, sharing responsibility, and managing uncertainty. Focus on the person requires refined abilities to observe, communicate, understand, and care. Commitment to patients and populations involves activism and advocacy. Family medicine can lead in redefining what it means to be a professional, a physician, and a generalist.