Urban Family Medicine

Book excerpt: Now, more than ever, Family Medicine is alive and well in the United States. The base of this medical specialty has traditionally been in the smaller cities, suburban communities, and rural areas of this country. Over the past decade, however, there has been a resurgence of interest in primary care in our major metropolitan areas as a solution to the high tech subspecialty pace of the tertiary care environment. A rebirth of urban family medicine has accompanied these pioneering efforts. To date, the accomplishments are substantial and the prospects are bright. There is still a long way to go and there are a significant number of hurdles to cross. Although diseases are generally the same wherever you are, their effects as illness on the individual and the family are strongly influenced by the environment and social milieu. Urban families have distinctive and diverse problems-cultural, economic, and ethnic. Training pro grams situated in the large cities must recognize these issues and include special emphasis on the situations that the family physician is likely to encounter during and after his training. There is very little research literature on the background and nature of special urban problems and these areas are the subject of several chapters of this long overdue volume devoted specifically to urban family medicine. Dr. Birrer has persuaded true experts to share their knowledge with the reader.