Internal medicine and family practice. Controversies, conflict and compromise

Internal medicine and family practice have come into conflict because both specialties consider primary care to be part of their "turf". Moreover, in academic medical centers there is competition for scarce resources, including patients and support for residents. Analysis of the number of physicians in practice as well as in training shows clearly that both internists and family physicians, as well as pediatricians and obstetricians, must participate in rendering primary care if the needs for this type of physician are to be met. Internal medicine also has to achieve a better balance between generalists and subspecialists, and family practice must define its limitations, monitor its rapid growth and assure the quality of its training programs. Most of these problems are internal to each speciality rather than between two specialties, and, where there is conflict, compromise is clearly possible.