The Shifting Social Scene and Family Medicine

Although by nature physicians are conservative, all of them in the past 30 years have accepted radical changes. For example, in 1930 there was no government involvement in medicine; today, virtually every physician collaborates with government in one way or another. In 1930 general practitioners in private practice dominated the field and were to be found in every community; today, specialists predominate and are concentrated around major medical centers in large cities and the affluent suburbs, while in the central cores of our metropolitan areas and in many rural communities, physicians are no longer available. In 1930 practice was almost exclusively devoted to acute infectious and contagious disease, infant and maternal mortality, and emergency surgery because the primary concern was the prevention of death; today, the concern is the prevention of illness, health care, chronic and degenerative disease, stress disorders, trauma, and major elective and corrective surgery. In 1930 medical