Family physician versus specialist family physicians: Curse or edge of collapse?

Abstract

The introduction and growth of family medicine as a specialty in Africa have produced mixed outcomes. While the consolidation of training has enhanced credibility, academic rigour, and career pathways, it has also contributed to a decline in the management of undifferentiated and complex cases, which form the bulk of primary care encounters. Increasingly, these cases are categorised as ‘minor ailments’, leading to reduced engagement of specialists with patients, communities, and the foundational principles of the discipline. This trend risks distancing family medicine from its holistic, community-oriented roots. Beyond qualification titles, the discipline must actively seek ways to sustain its presence in routine consultations, ensuring that specialists remain engaged in everyday patient encounters while applying advanced skills to address complexity.