Coping with family medicine put-downs.

F physicians often feel devalued in our complex and “specialized” world. Specialization and subspecialization are highly valued; generalism is discounted. Family doctors are not alone in feeling disparaged; other generalists, such as general internists, general pediatricians, and general surgeons, sometimes feel this way too. Our colleagues in the traditional specialties also experience put-downs. Surgeons can be stereotyped as unthinking cutters; psychiatrists are “crazy” doctors; anesthesiologists are just “gas passers”; and obstetricians are not “real” surgeons. Family physicians can have an important role in opposing this unhealthy competitiveness and systemic denigration of other physicians. Similar forces are at work in nursing, pharmacy, and social work. Family physicians can lead with an attitude that all disciplines in medicine have a valued role and all health care providers are welcome partners in caring for patients and their families. Th e disparagement of family medicine is often endemic in teaching hospitals; medical students, family medicine residents, and attending family physicians experience it regularly. Disparagement is often combined with contempt for care provided in nonteaching hospitals or rural settings. Some university departments of family medicine have begun reviewing all undergraduate case-based learning to ensure comments that deride community-based care or family medicine are removed. In crafting responses to put-downs, we should acknowledge the issue but challenge the stereotyping or injustice and promote dialogue. Here are some simple but eff ective ways of coping with put-downs. Th ey have worked for me, for family medicine residents, and for medical students interested in family medicine.