With family doctors increasingly overburdened, bureaucratized, and burned out, how can the field change before it's too late? Over the past few decades, as American medical practice has become increasingly specialized, the number of generalists—doctors who care for the whole person—has plummeted. On paper, family medicine sounds noble; in practice, though, the field is so demanding in scope and substance, and the health system so favorable to specialists, that it cannot be fulfilled by most doctors. In Searching for the Family Doctor, Timothy J. Hoff weaves together the early history of the family practice specialty in the United States with the personal narratives of modern-day family doctors. By formalizing this area of practice and instituting specialist-level training requirements, the originators of family practice hoped to increase respect for generalists, improve the pipeline of young medical graduates choosing primary care, and, in so doing, have a major positive impact on the way patients receive care. Drawing on in-depth interviews with fifty-five family doctors, Hoff shows us how these medical professionals have had their calling transformed not only by the indifferent acts of an unsupportive health care system but by the hand of their own medical specialty—a specialty that has chosen to pursue short- over long-term viability, conformity over uniqueness, and protectionism over collaboration. A specialty unable to innovate to keep its membership cohesive and focused on fulfilling the generalist ideal. The family doctor, Hoff explains, was conceived of as a powered-up version of the "country doctor" idea. At a time when doctor-patient relationships are evaporating in the face of highly transactional, fast-food-style medical practice, this ideal seems both nostalgic and revolutionary. However, the realities of highly bureaucratic reimbursement and quality-of-care requirements, educational debt, and ongoing consolidation of the old-fashioned independent doctor's office into corporate health systems have stacked the deck against the altruists and true believers who are drawn to the profession of family practice. As more family doctors wind up working for big health care corporations, their career paths grow more parochial, balkanizing the specialty. Their work roles and professional identities are increasingly niche-oriented. Exploring how to save primary care by giving family doctors a fighting chance to become the generalists we need in our lives, Searching for the Family Doctor is required reading for anyone interested in the troubled state of modern medicine.

Heirs of General Practice is a frieze of glimpses of young doctors with patients of every age—about a dozen physicians in all, who belong to the new medical specialty called family practice. They are people who have addressed themselves to a need for a unifying generalism in a world that has become greatly subdivided by specialization, physicians who work with the "unquantifiable idea that a doctor who treats your grandmother, your father, your niece, and your daughter will be more adroit in treating you." These young men and women are seen in their examining rooms in various rural communities in Maine, but Maine is only the example. Their medical objectives, their successes, the professional obstacles they do and do not overcome are representative of any place family practitioners are working. While essential medical background is provided, McPhee's masterful approach to a trend significant to all of us is replete with affecting, and often amusing, stories about both doctors and their charges.

This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice. After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed. Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the “silver tsunami.” Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management. This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients. This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helping them to better understand some features of primary care and to more fruitfully interact with family doctors.

'McWhinney's Textbook of Family Medicine' is one of the seminal texts in the field, defining the principles and practices of family medicine as a distinct field of practice. The fourth edition presents six new clinical chapters of common problems in family medicine.

This book contains my reflections upon my 26 years as an "old time" generalist family physician in rural America. It is merely a collection of stories that depict some of my many experiences over the years. The stories mirror those of many of my generalist colleagues who have experienced "the trenches" of rural primary care. My stories span the breadth and depth of the discipline of rural family medicine. Stories range from assisting mothers giving birth to caring for and comforting those at the end of life, from performing surgery to becoming involved in one's community, and from making house calls to providing emergency room care. Some are silly, some are sad, some are funny, and some may make you mad. JIMMIE ASHCRAFT, M.D. Doctor Ashcraft is a graduate of the University of Oregon Medical School. He was a member of the clinical staff of the University of Washington Medical School for 30 years. Doctor Ashcraft and his wife, Kay, live in Montana. They have three grown children and six grandchildren.

Meet Barry Ladd. He is a family physician who practiced medicine for thirty years in a small country town, forty miles south of a major city. He calls it "Our Town", because the residents, including himself, so personally identified with the community. In the thirty years that Ladd practiced in "Our Town", he delivered fifteen hundred babies and had one hundred and eighty thousand office visits. He delivered the babies of the babies, and took care of four generations in the same family. During that time, there was an explosion of technology and scientific information. The practice of medicine shifted from being more of an art to being more of a science. During this time, Ladd was a participant and observer. He saw how personal events and decisions played out over time. He tells his readers what he saw, heard, and felt. These are all true stories. Some are composites of several people. The names have been changed.

This text defines and conceptualizes the field of family medicine. The first edition was widely acclaimed for its originality, depth of analysis and elegant style. The book has now been extensively revised. Much new material has been added on the patient-centered clinical method, illness narratives, the biological basis of family medicine, health promotion, the concept of risk, and the contribution of evidence-based medicine. A new chapter on alternative (complementary) medicine fills the need for reliable information on this topic.