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Admiral James Stockdale explained his survival as a prisoner of war in Viet Nam when many of his co-prisoners did not in what has been called "The Stockdale Paradox": "I never doubted that I would get out, but also I would prevail in the end . . . You must never confuse faith that you will prevail in the end--which you can never afford to lose--with the discipline to confront the most brutal facts of your current reality, whatever they might be." 1
Dr. Grumbach declares the brutal facts of US healthcare in the United States' late stage capitalist economy and the near collapse of primary care. He exploits the 2022 National Academy's primary care report's call to restore primary care as a common good and shouts a plea for "COUNTERCULTURAL PROFESSIONALISM." This reflection constitutes a sufficient "call to arms" for those who are prepared to restore the social contract between medicine and the public. Is anybody listening?
Will national family medicine organizations invite patient and community advocates to join them in the radical proposition of liberating primary care as a common good, funded as a common good, PC4All? Will departments of family medicine recast their gaze from survival and legitimation in academic health centers toward surrounding communities as their natural habitat and place to serve? Will family medicine residencies reaffirm core values and also escape the limitations of tweaking a half century old model and dramatically redesign their structures and curricula to prepare the best generalist personal physicians and their necessary teams? Is there an existing organization that can forfeit protectionalism of its tribes for collaboration with those who can share what they can contribute to providing proper primary care for all? Or, is it time to raise the PC4All movement de novo?
1. https://readingraphics.com/the-stockdale-paradox/?ref=StoreYa&utm_source...
(accessed March 28, 2023)