Pocket History

With generous support provided by gifts from the Franciscan Health Indianapolis Family Medicine Residency and Eli Lilly and Company, the Center for the History of Family Medicine (CHFM) created a new publication, entitled A Pocket History of Family Medicine in the United States.

Throughout every era of U.S. history, general practitioners (GPs) and family physicians (FPs) have been on the front lines of the American health care system. Family medicine practitioners were signers of both the Declaration of Independence and the Constitution, have served as governors, cabinet members, and congressmen; two have even served as U.S. surgeons general.

The Pocket History is intended as a reminder of the important role family physicians have played as the champions of health care through U.S. history.

Colorful and richly illustrated, the small (8 ½” x 4”) 36-page “pocket” size booklet is designed to give a brief history of the specialty to family physicians, students, residents, and members of the public to help educate them on the history and evolution of family medicine.

The Doctor" by Sir Luke Fildes (1891) ...important to wash the hands and to wear rubber gloves, but 30 or more minutes of scrubbing was considered ridiculous . Hertzler also thought a mask unnecessary so long as the surgeon was not breathing with mouth wide open into an open wound. And yet, he prided himself on causing no operative infections. Indeed, during early America, and even into the turn of the 20th century, most physicians would be considered generalists who did it all, including surgery. But over time, this began to change. Some physicians became so proficient in the surgical techniques of the day (limited though they were), that they confined their practices to surgery. Becoming a "surgeon" gradually became more and more lucrative, and this created a strong incentive for physicians to become proficient in the surgically oriented areas of medical practice. Later, as technology advanced and physicians acquired even more technical skills, more of these generalists simply devoted almost all of their time to surgery, or other specialized areas.

The Growing Movement Toward Specialization (1910-1947). At the same time these reforms were being implemented, exciting new developments in technology and science were also taking place. As a result of these changes, as the knowledge base of the medical profession increased, the pace toward specialization also greatly accelerated. This led to the formation of medical specialty organizations and organizations that prcvided voluntary examinations tor physicians wishing to document their expertise, beginning in 1917 with ophthalmology; and by 1940, a total of 16 medical specialties had been established. As specialists increased, the status of the general practitioner within the medical profession declined. This became especially apparent during World War II, when many GPs serwd on the front lines of the conflict, and in so doing disccwered that they were given less preferential treatment and assignments compared with their specialist physician colleagues. By the end of the war fewer physicians were in general practice, and ii was becoming increasingly clear that many small towns, especially those in rural communities that once had a general practitioner, no longer had one because the general practitioner was not being replaced. It was assumed by many in American medicine that the general practitioner would soon go the way of the dinosaur and become "extinct."

Donate to the CHFM Endowment and Take a Little History with You

The Pocket History is a great learning tool for medical students―and a great reminder to family physicians―of the proud legacy and heritage of the specialty.

Copies of the Pocket History are available for a suggested donation of twenty-five dollars to the American Academy of Family Physicians Foundation. All proceeds go to the CHFM Endowment. The CHFM Endowment, a long-term growth fund, was established in 1998 with the goal of establishing the Center as a permanently self-supporting and self-sustaining entity within family medicine.

Cover of "A Pocket History of Family Medicine in the United States"