Development of the Specialty

As long ago as 1923, Francis Peabody commented that the swing of the pendulum toward specialization had reached its apex, and that modern medicine had fragmented the health care delivery system too greatly. He called for a rapid return of the generalist physician who would give comprehensive, personalized care.

Dr. Peabod/s declaration proved to be premature; neither the medical establishment nor society was ready for such a proclamation. The trend toward specialization gained momentum through the 1950s, and fewer physicians entered general practice. In the early 1960s, leaders in the field of general practice began advocating a seemingly paradoxical solution to reverse the trend and correct the scarcity of general practitioners—the creation of still another specialty. These physicians envisioned a specialty that embodied the knowledge, skills, and ideals they knew as primary care. In 1966 the concept of a new specialty in primary care received official recognition in two separate reports published 1 month apart. The first was the report of the Citizens' Commission on Medical Education of the American Medical Association, also known as the Millis Commission Report.

The second report came from the Ad Hoc Committee on Education for Family Practice of the Council of Medical Education of the American Medical Association, also called the Willard Committee (1966). Three years later, in 1969, the American Board of Family Practice (ABFP) became the 20th medical specialty board. The name of the specialty board was changed in 2004 to the American Board of Family Medicine (ABFM).

Much of the impetus for the Millis and Willard reports came from the American Academy of General Practice, which was renamed the American Academy of Family Physicians (AAFP) in 1971. The name change reflected a desire to increase emphasis on family-oriented health care and to gain academic acceptance for the new specialty of family practice.

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