To the Editor:

I was very interested in “Family Medicine Takes Center Stage” [November/December 2003, page 43], particularly in how “medical students ... put income at the top of the list of drawbacks for going into family medicine today.” This is certainly reasonable and partially why I initially chose anesthesiology as a specialty. I have since fallen in love with family medicine and would like to suggest how to boost student and professional interest in the specialty: emphasize procedures. The money is in procedures.

As primary care physicians, we should be thoroughly trained in screening procedures (e.g., colonoscopy, colposcopy, stress testing, mammography). After all, who better to do screening procedures than primary care doctors? Though this is theoretically possible where I train, I realize that the glut of specialists, along with reimbursement and privileging issues, would make this difficult. Perhaps family medicine residency programs could emphasize just one or two types of procedures. Then they could graduate competent family physician-colonoscopists or family physician-preventive cardiologists, like some of the more rural residency programs do.