I AM a Specialist, for God's Sake!
In the old days, after medical school everyone did what was called a 'rotating internship'. After a year of rotating through various specialties, doctors were awarded a general license. They could either practice as a General Practitioner, or they could return to residency to specialize. Since everyone had a GP license after one year of residency, they could also moonlight for extra money through the rest of their residency.
Things are different today. They did away with the rotating internship years ago, and along with it went the concept of the General Practitioner. All areas of medicine required a unique residency-- two for family medicine, four for internal medicine and pediatrics, and five for most other areas of medicine.
Having recently switched from a five year program to a two year program, I've been on the receiving end of a special brand of elitism. Many doctors have the mistaken impression that family medicine is something that anyone can do. Many feel that they are somehow better clinicians than family doctors because they have specialized training. I didn't think I felt like this before I changed programs, but it still surprised me how much about family medicine I didn't know when I started. Most specialites know a lot about a narrow range of topics... family doctors are expected to know a little bit about everything. Sure, if you're working in a mid-to-large sized centre you can refer anything that you're not comfortable that you can manage effectively, but in many cases you're expected to know as much about prostate cancer as you do about chronic sinusitis.
So it's no surprise that I find it irritating when people declare themselves specialists as though it's something more impressive than family medicine. Family docs are more likely to really be making a difference in people's lives than the surgeon who took out your gallbladder, the dermatologist that fixed your rash or the radiologist who read your CT scan but has never actually seen your face. Not to bash any of these specialties, I just don't understand why family docs are seen as the generic version of the physician. Of course, the ability of your family doctor to actually make a difference in your life depends entirely on whether or not you've lucked into a good one. And at a time when over 4 million Canadians don't have ANY family doctor, even having a bad one is sometimes the lesser of two evils.
I do honestly believe that family doctors are underappreciated and underpaid. But that's another post.