Is There a Future for Behavioral Scientists in
Academic Family Medicine?
Johanna Shapiro, Ph.D.f
Yves Talbot, M.D.t
This article examines the issue of whether
nonphysician teachers of behavioral sci-
ence have a long-term future in academic
family medicine. While the question is
answered in the affirmative, several sources
of threat to the special relationship between
family medicine and behavioral scientists
are investigated. Various formulations of
this working relationship are considered,
and a trilateral clinical model is proposed,
which emphasizes collaboration regarding
multiproblem patients; the establishment
of interdisciplinary research endeavors;
and the integration of the role of therapist/
consultant to the system, which will pro-
vide a counterpoint perspective to the
traditional medical world view through
ongoing commentary and dialogue. The
article concludes with a recommendation
that opportunities for participation and
influence be available to behavioral scien-
tists within the system of academic family
medicine.
Fam SystMed 10:247-256, 1992
D
O we need a second generation of
behavioral scientists? In the life cycle
of family medicine, we are reaching a point
f Department of Family Medicine, University of
California Irvine Medical Center, P.O. Box 14091,
Orange CA 92613-4091.
$ Department of Family Medicine, Mt. Sinai Hospi-
tal, Toronto, Canada.
where, as behavioral scientists, we must
ask: Who will come after us, and what will
be their role in family medicine? It is
presumptuous to attempt to answer these
questions completely; in part, the answers
will emerge from the ongoing interaction
of this next generation of aspiring behav-
ioral scientists with the future realities of
family medicine. But unless we, in our
generation at least, seriously contemplate
the question and make preparations for a
partial groundwork from which answers
can arise, it is a real possibility that no one
may follow, and that the special relation-
ship that has existed between the family
physician and the behavioral scientist may
become nothing more than a historical
aberration.
The "Special Relationship"
Before considering the reasons for this
pessimistic assessment, a brief review of
this special relationship is in order. Train-
ing in family medicine traditionally has
included a strong, formal interdisciplinary
component (13). Family medicine is the
only medical specialty that currently ex-
pects the in-house presence of a nonphysi-
cian as part of every department's educa-
tional unit. Because of this, family medicine
training has chosen to define itself offi-
cially as containing an interdisciplinary
dimension.
In part, the emergence of this interdisci-
plinary, pedagogical approach was influ-
247
Family Systems Medicine, Vol. 10, No. 3, 1992 © FP, Inc.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.