Heirs of General Practice By John McPhee

At a time when reading the news makes me horrified, and then more horrified, it was a great relief to read this book about doctors choosing to go into family practice--to choose to work in rural settings, treat the whole patient, and even make house calls. McPhee is careful not to mythologize these real people--they are not SuperDocs, but they are truly admirable human beings. And, of course, since he's a brilliant writer, McPhee has fun describing doctors and patients and adding the occasional clever spin, or twist, or joke. My favorite is this phrase

...the town's other doctor wears a cross in his lapel and has personally been obstetricated twice.

which sent me to Google in vain before I realized it was the medical equivalent of born again.

Heirs of General Practice I come from a family of general practitioners - my mother was a G.P. and my sister followed in her footsteps - and I am a fan of John McPhee's writing, in general. So I expected to like this book more than I actually did. The book follows the standard McPhee schema - in-depth reporting on a very specific topic, in this case doctors who choose to work as general practitioners. McPhee provides vignettes of a dozen or so such doctors, almost all of them working in Maine.

McPhee is usually very effective in working from the specific to reach more general insights, and it is clear that he would like to do the same here. That is, by focusing on doctors who have opted out of the mainstream, he would like to illuminate some general truths about the practice of mainstream medicine. However, I think his success in doing so is limited, rarely rising above statement of the obvious. By focusing his microscope only on family practitioners working in Maine, the generalizability of any lessons they might offer is questionable. The needs of communities in Maine cannot be considered particularly representative of the U.S. in general.
So the book never really becomes anything more than a series of isolated vignettes of some individual 'maverick' doctors.

Which is interesting as far as it goes, but I wish McPhee had been able to do more with the material. By the end I felt that an opportunity had been missed. Heirs of General Practice This book about family practice in medicine and the doctors who, well, practice it was written in the 1980s but does not feel dated. Ailments haven't changed much, really, and I suspect Maine, where most of the doctoring in this book takes place, hasn't changed much either.

I read McPhee because he has a way with words, like describing the doctor who wears a cross in his lapel and has personally been obstetricated twice.

I also read him because of the cool things I learn. Like about the condition called Iowa ear. The farmer on his tractor looks over his right shoulder, watching his planter or plow and sighting back down the row. This aims his left ear toward the tractor's engine. Which causes hearing loss, invariably in the left ear.

It's hard to describe how happy knowing that little chestnut makes me.

FYI: This book also appears in the McPhee collection: Table of Contents. Heirs of General Practice Delightful quick read! Heirs of General Practice This was EXCELLENT. Extremely engaging, fascinating, and helped to lessen the stigma surrounding family practice physicians. I am not entering the medical field and I found this to be an enjoyable read. Highly recommend for anyone interested in the doctor-patient relationship. Heirs of General Practice

review Heirs of General Practice

Heirs of General Practice is a frieze of glimpses of young doctors with patients of every age—about a dozen physicians in all, who belong to the new medical specialty called family practice. They are people who have addressed themselves to a need for a unifying generalism in a world that has become greatly subdivided by specialization, physicians who work with the unquantifiable idea that a doctor who treats your grandmother, your father, your niece, and your daughter will be more adroit in treating you.

These young men and women are seen in their examining rooms in various rural communities in Maine, but Maine is only the example. Their medical objectives, their successes, the professional obstacles they do and do not overcome are representative of any place family practitioners are working. While essential medical background is provided, McPhee's masterful approach to a trend significant to all of us is replete with affecting, and often amusing, stories about both doctors and their charges. Heirs of General Practice

I received this book from a patient and ever so grateful. It offers a beautiful and (almost) timeless lens into the joys, complexities, rewards and struggles of Family Practice. I had to keep glancing at the year it was published. It’s soon to be a staple on my desk to revisit when I need a reminder of why I love what I do in Family Medicine. Heirs of General Practice A fun, often humorous, look into the need for family medicine. It follows about 12 doctors and shares why certain patient presentations would best be served by the family doc. I thought all in all it was a little hard to follow, but the topics made for a great book discussion. I think I would actually read it again one day, since it was such a short read and gets your mind thinking, especially if one is considering family Med. Last thought; very impressive how this book was written in the 80’s but the argument fits the current healthcare climate just as well. Heirs of General Practice You guys, my dad is in this book! Heirs of General Practice This book jumps a lot which McPhee employing several different narrative and investigative writing styles. The beginning and throughout are too choppy moving from one patient to next as to imitate the sense the family/general practitioner may experience seeing many diverse patients consecutively. While this may mirror the feeling of witnessing a quick patient turnover, I would have appreciated it if McPhee used his interviewing skills to investigate further and provide more information than just the superficial. Even if decisions are made quickly, they require years of experience to make.

The big question of the book is whether General Practice is justified in modern medicine as a specialty and whether its doctors can keep up with the vastness of knowledge. He makes the case that in rural areas, as in Maine where the book is set, that only GPs have the interest and time to get to know and follow generations of families. It also appears that the GPs knowledge is mostly too superficial to meet the need. In all, I wish McPhee would have gone more in-depth with both the medical diagnoses and the interpersonal interactions. He reveals, to his credit, a lot on inter-doctoring politics and territory grabs. It would be interesting to read essays on other medical specialties. Heirs of General Practice An interesting and entertaining glimpse into rural family medicine. Even though this was written in the '80s, it still feels incredibly relevant, and rings true with what I've been seeing firsthand in my work as a medical scribe at a family practice. McPhee is also a great writer. He surrounds vignettes of doctors and the patients they see with context around the development of the field of family medicine and the cultural context of rural Maine, and writes in an engaging and accessible voice. Heirs of General Practice