I am sympathetic with the concerns expressed by Dr Gillette. However, I think he misreads my line of argument. Nothing in my essay suggests that family medicine should slavishly adopt the current academic model and sacrifice humanism or care for common problems for science. Rather, my article insists that these are among the essential contributions of family medicine to medical education and practice.
I do argue, however, that these contributions are best developed in the academic setting and not out of it. Family medicine can now shape its own academic destiny; it has the intellectual resources to do so. It must respond in its own way to the challenges my article poses.
There is, after all, no inherent contradiction between intellectual rigor and a humanistic approach to patient care. We enhance—rather than lose—our humanity the more we understand and can rationally justify our decisions. Is anything less humane