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The article by Douglas et.al. is an important contribution to what must be an ongoing search in family medicine to identify factors which are likely to contribute to satisfaction and a positive spirit in family physicians.
Medicine is about service - to patients and communities. This study, not surprisingly to many of us, finds that family physicians from underrepresented groups in society have a more positive attitude about their work - and coincidentally, their work is often in more challenging communities. Three quarters of a century ago, the Psychiatrist Robert Coles in his landmark five volume series Children of Crisis (Little Brown and Co Publisher) focused on how children subjected to dire conditions of poverty, racism and general deprivation managed to surmount those challenges and go on to successful adulthood and lives of service. Supportive family members, teachers, and adults were critical to children finding resilience.
My suspicion is that, when the next stage of the research by Montgomery and his colleagues gets underway to find out why and how the family physicians from underrepresented groups in their study find a more positive and satisfying life's work, they may find some of the same factors as Coles did with children. A sense of purpose, service and positive contribution to communities that many family physicians feel will add to that resilience and, I hope, sustain the discipline and inspire more young people to lives caring for their communities. Coles focused on children who were successful in their lives, despite obstacles, as a way to help other children in the future. We need to do the same with family doctors.