The development of family medicine in Israel

Israeli family medicine provides an example of the accelerated development of a new discipline. This development occurred in a highly dynamic and rapidly growing society against a background of conflicting cultural traditions within the health care field. The developmental stages included: 1) the preponderance of specialists over generalists, 2) the introduction of family medicine teaching into the undergraduate medical curriculum, 3) the achievement of family medicine's independence from the status of a branch of internal medicine or community medicine, 4) the development of the residency training programs, and 5) the establishment of a national academic infrastructure. This paper analyzes the unsolved problem of gaining significant numbers of university academic appointments. Also, two major challenges for the future are examined: 1) the integration of preventive care into family practice, and 2) the exposure of primary care to competition from hospital-based specialists in an atmosphere of increasing commercialism. The Israeli experience forms a basis for comparison for family medicine in other countries.