40 Years in Family Medicine

by Joseph E Scherger, MD, MPH

Review by Robert W Hogan, MD

Perm J 2015 Spring; 19(2):e112 [Full Citation]


112Joseph Scherger, MD, MPH, has provided those of us who enjoy his writing with a 426-page soft cover, self-published monograph consisting primarily of a compilation of previously published works. The title suggests an autobiographical work, and as the reader proceeds through the timeline in the work, it becomes clear that in a sense 40 Years in Family Medicine is not exactly an autobiography, at least in the conventional sense. This is an impressive collection of short pieces, written by a very distinguished clinician-scholar.

The work begins with an essay first published in 1975, written while Dr Scherger was a medical student. It pertains to his observations about preceptorship in Family Medicine.

As one proceeds through the book, the voice of the author matures and takes on a futurist dimension, going beyond describing which particular foment is roiling the Family Medicine waters of the moment (and over the years there have been many) toward visions of what medical practice in the primary care or Family Medicine domains will be like in a not-too-distant future. In the role of futurist, Dr Scherger has proven to be remarkably prescient.

There are glimpses of the author's struggles, for example, "I was not a natural writer." Perhaps, but if so, Dr Scherger has more than overcome any impediment with diligence and intelligence and well-expressed insight.

Family Medicine developed as a reform movement. Born in the aftermath of the socially tumultuous 1960s in an optimistic time when change for the better seemed possible in all things, idealism was widely embraced and respected. Arguably our current era has developed into a time of cynicism. Perhaps Family Medicine should be thought of as a reactionary movement—too much idealism at the start, which then led to missteps, disappointments, and retrenchment.

Dr Sherger's book is beyond a chronicle of personal development. By virtue of having practiced from the earliest years of Family Medicine and having been close to the universities throughout much of his career, his commentaries reflect a sort of intellectual chronicle. For a person "not a natural writer," Dr Scherger's essays illustrate how thoughtful commentary on the discourse of the day over time becomes a de facto history.

Dr Scherger is clearly one of the most distinguished members of an entire generation of family practioners, having been present at the beginning of the movement in the 1970s, and still being present and participating in clinical practice, academic affairs, and senior leadership roles almost too numerous to count. He has maintained a stream of cogent insightful commentary over a period of four decades.

I was personally influenced by some of the early greats in Family Medicine, including the charismatic Eugene Farley, MD; Jack Froom, MD; and Paul Frame, MD, and by having either heard or read Ted Phillips, Gayle Stevens, and others cited in Dr Scherger's book. Back in the day, as a student, my peers were most awed by "Triple Threat" physicians, gifted individuals who easily moved between the roles of clinician-teacher-researcher.

Dr Scherger's book documents his status as something more, a quadruple threat—physician clinician, physician administrator, physician leader, and physician author/futurist. Students in the field, budding leaders in Family Medicine, young academic family physicians wishing to understand how the field grew and developed, policy makers, and anyone else who aspires to comprehend the origins and development of Family Medicine as a discipline should have a well-thumbed copy of this book on their bookshelf.


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