The specialty of family medicine arose out of a combination of American public and professional concerns regarding fragmentation of health care and was intended to foster a type of physician with a scope of clinical competence that would allow the patient, not the disease, to be the focus. Family physicians serve as the patient's personal physician and provide entry to the health care system, provide comprehensive care, maintain continuing responsibility for the patient including necessary coordination of care and referral, and provide care appropriate to the patient's physical, emotional, and social needs in the context of family and community. The specialty is currently second only to internal medicine in size, and makes a significant contribution to patient care and medical education. As family medicine looks to the future, some of its challenges include continuing to attract medical students to the specialty, refine research themes, and gain further acceptance in academic medical centers.