Power in academic medicine.

The inherent strengths from which family medicine can gain power in the academic medical center include the following. 1. Family medicine is the ambulatory primary care discipline. Consider increasing your capabilities of teaching in ambulatory settings. With the changing nature of the hospital patient population, it is becoming increasingly difficult to find a non-seriously ill patient who is alert and cooperative for simple teaching programs such as basic history taking and physical diagnosis. One can recruit more practicing family physicians as part-time faculty. In some medical schools the Introduction to Clinical Medicine field experience is in the office of practicing physicians. One might consider assuming responsibility for a neighborhood health center, particularly if this is a designated U.S. Public Health Service Corps Site. There would be an advantage to having students experience firsthand this mechanism of financing the medical education of primary care physicians. One might consider developing a purely private teaching practice. One could take a university faculty salary and divide it among three or four people in a group practice. This would compensate for the extra time it takes to have students and/or residents seeing patients in private offices. 2. Graduates of family practice residency programs comprise the major primary care referral base for open staff hospitals. Energies devoted to recruiting residency graduates to use our teaching hospitals will be well spent. Imaginative joint ventures between the hospital and the departments and/or graduates would help these recruiting efforts. The gradual increase in this primary care referral base over several years would greatly strengthen the position of family medicine within the academic medical center.(ABSTRACT TRUNCATED AT 250 WORDS)