Family Medicine and Academic Health Centers

The world is different now, but the sounds are the same to those of us who have had to endure negativism over the years despite our love of the speciality. The attacks now are not just more of the same. In the past there were no data to back the claims. EBM makes our adversaries look for "evidence" (sometimes reminds me of How to Lie with Statistics). I recently went back and got the column Denise Rodgers wrote in FM April 2002 and I believe she excerpted much of this at an address to the AFPRD. She spoke of Culture, FM and AHC's. Dr Rodgers noted that we now have a history of successes, but more importantly to our adversaries (or competitors) we have failures. These failures are documented with data. She alluded to the fact that we failed to understand that to succeed in the AHC you need money not good intentions, and we failed to get the needed presitious grants. We have failed to become recognized as "experts". We have failed to develop a core critical mass of Federal and State legislative friends. We have failed to become valued to the AHC and in most cases to organized medicine. As she pointed out we failed as the gatekeepers (our patients hated our role and the insurers and HMOs have less faith in our worth to them). We failed to provide a steady stream of paying patients to our colleagues in other specialities. We failed to understand that status and money talk. We have a multitude of successes to offset these failures, but can we prove it? Our failures can be proven. We need to look hard at the data as it is viewed from the "other side". How do we look and how can we change it. Dr Rodgers I hope, will agree that we need to act like the successful members of AHC's in order to succeed (i.e. our specialtiy's liberal agenda of quality patient care for all requires a more conservative approach if it is to succeed.)

Competing interests:   None declared