History and Definitions of FM
Dr. Faisal Al Hadad
Consultant of Family Medicine
& Occupational Health
Centuries ago people tried to take care of
themselves before resorting to “healers”
17th and 18th centuries
Relatively few physicians were available to the general
Most of them practiced in 3 different settings:
– Traveling around the country
– In urban centers where they served the growing middle class
– As personal attendants to wealthy or aristocratic families.
Surgeons trained by apprenticeship and apothecaries who
dispensed and sold drugs provided the medical needs to
poorer and rural people.
Most physicians were “General Practitioners.”
A growing shift towards specialization took place
throughout the 1920s and 1930s.
Between 1931 and 1974, physicians classifying
themselves as “General Practitioners” declined from
83% to 18%, and there was a concomitant rise in
Fragmented Patient Care
Many people felt like the trend toward specialization had
fragmented patient care and weakened the patientphysician relationship.
“There are 57 different varieties of specialists to diagnose
and treat 57 different varieties of diseases, but no physician
to take care of the patient.”
The decline in the number of “general practitioners” and the
public concern over fragmented medical care led to the
movement to create the “specialty” of Family Medicine.
Generalist began to initiate steps to elevate general
practice to “specialty” status.
Their goal was the development of a curriculum and
creation of a formal certification board.
Generalists were claiming equal training and equal
WHO (1963) report:
"Training of Physicians for Family Practice" which recommended a
postgraduate study program specifically designed to meet the
needs of the General Practitioner.
The Millis Report (1966):
The Millis Report became a forerunner for the development of
Family Practice residency programs.
Dr. Millis became known as the “grandfather of Family
Conclusion of Millis Report: Family Practice needed to be a
Board Certified specialty.
Definitions of FP/GP
American Academy of Family Physicians (AAFP)
American Board of Family Practice (ABFP)
Royal Australian College of General Practitioners (RACGP)
Royal College of General Practitioners (RCGP-UK)
Royal New Zealand College of General Practitioners (RNZCGP)
The World Organization of National Colleges and Academies of
General Practice/Family Medicine (WONCA)
American Academy of Family
- Family medicine is the medical specialty which
provides continuing, comprehensive health care for
the individual and family.
- It is a specialty in breadth that integrates the
biological, clinical and behavioral sciences.
- The scope of family medicine encompasses all ages,
both sexes, each organ system and every disease
Royal Australian College of General
General Practice is that component of the health
care system which provides initial, continuing,
comprehensive and coordinated medical care
for all individuals, families and communities and
which integrates biomedical, psychological,
social and environmental understanding of
Royal College of General Practitioners
General practitioners (GPs) are best defined by the unique
nature of the doctor-patient relationship. GPs are personal
doctors, primarily responsible for the provision of
comprehensive and continuing medical care to patients
irrespective of age, sex and illness. In negotiating management
plans with patients they take account of physical,
psychological, social, and cultural factors, using the knowledge
and trust engendered by a familiarity with past care.
They also recognise a professional responsibility to their
community. GPs exercise their professional role by promoting
health, preventing disease and providing cure, care or
palliation. This is done either directly, or through the services of
others according to health needs and the resources available
within the community they serve.
General practice / family medicine is an
academic and scientific discipline, with its
own educational content, research, evidence
base and clinical activity, and a clinical
specialty orientated to primary care.