Federal-state synergy in family medicine education

During the 1960s national policy groups assessed the consequences of a four-decade decline in the nation's number of general practitioners. Various proposals were offered to make general practice a more attractive specialty. Most of the proposals have been institutionalized by means of a family practice specialty board, accredited family practice residency programs, and academic family practice units in medical schools. In retrospect, two events can be identified as critical factors in the successful launching of the family practice specialty: (1) the merging of the movement to make real the theoretical, normative concept of the primary care physician proposed in the academic literature with a reform movement within the clinically based, politically astute American Academy of General Practice and (2) the establishment of extramural funds for family practice, which helped it gain a crucial foothold within academic medical centers. The broad themes of the family practice movement, established in the 1960s and 1970s, continue to be appropriate themes for the 1980s and 1990s.