An Extended Metaphor: Family Medicine as Family

JOHANNA SHAPIRO, Ph.D., YVES R. TALBOT, M.D., F.R.C.P.

With the development of the specialty of family medicine, family physicians and behavioral scientists have been working together in medical settings for the past 20 years. Lack of clarity of goals, divergence in values, and different professional training have resulted in tension between the two disciplines. However, these tensions need not be paralyzing for the field and, in fact, may reflect necessary developmental milestones. This article uses the analogy of the family to describe some of the difficulties in the relationship between family physician, resident, and behavioral scientist. Using a Bowenian model, it also explores solutions to these relational problems. It is hoped that a more harmonious relationship might allow both family medicine and behavioral science to differentiate from their families of origin and to begin tapping the creativity required for the ongoing development of the discipline of family medicine.

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