ENTHUSIASM FOR PRIMARY-CARE - COMPARING FAMILY MEDICINE AND GENERAL INTERNAL-MEDICINE

OBJECTIVE: To compare attitudes and perceptions of primary care among faculty, students, and residents oriented toward family medicine (FM) end general internal medicine (GIM). DESIGN: Descriptive study using c onfidential telephone interviews. PARTICIPANTS: National stratified pr obability sample of FM and GIM faculty (n = 68), residents (n = 196), and students (n = 81). MEASUREMENTS AND MAIN RESULTS: We created indic ators for attitudes toward primary care among the faculty that include d perceptions of medical practice, experiences within the academic env ironment, and support for primary-care-oriented change, For the studen ts and residents, we explored their perceptions of faculty and residen t attitudes toward primary care, their perception of encouragement to enter primary care, and their satisfaction with training. Family medic ine faculty showed more enthusiasm for primary care as manifested by t heir greater likelihood to endorse a primary care physician to manage a serious illness (FM 81.3% vs GIM 41.1%; p < .01), their strong encou ragement of students to enter primary care (FM 86.2% vs GIM 36.3%; p < .01), and their greater support for primary-care-oriented changes in medical education (FM 58.8% vs GIM 14.7%; p < .01). Family medicine st udents and residents were more likely to perceive the primary care fac ulty as very satisfied with their work (FM 69.2% vs GIM 51.5%: p < .05 ), to feel strongly encouraged by peers toward primary care (FM 59.5% vs GIM: 16.1%: p < .0001), and to have a primary care role model (FM 8 4.3% vs GIM 61.3%: p < .05). CONCLUSIONS: Family medicine faculty, stu dents, and residents showed a consistent pattern of greater enthusiasm for primary care than their GIM counterparts, This may be a reflectio n of the different cultures of the two disciplines.