Family docs are a dying breed in urban centers because of the significant overlap among family practice and three other specialties--general internal medicine, ob/gyn, and pediatrics. Some people (including my friend who is a resident at Duke) claim that FP's lack adequate training to compete against specialists in the other primary care fields. Internists are more qualified than FP's to treat illnesses pertinent to internal medicine; likewise, a gynecologist/obstetrician receives superior training in the areas of female health and delivery of babies; and, of course, pediatricians receive more thorough training in children's health. These disparities in training between FP and other primary care specialties are incontrovertible; since FP's have to be able to do everything (surgery, obstetrics, etc.) their training during residency lacks depth.
Thus, if you're planning to start a career as a family doc, your best bet is to practice in a rural setting. In small towns, the sheer variety that is often touted as a big plus of family practice is a reality; small town FP's perform surgery, deliver babies, treat all age groups, etc. However, given the hyperlitigious atmosphere of America today, I would seriously reconsider your career aspirations, should you want to become an FP in an urban center. "Variety" for an urban FP is a lawsuit waiting to happen, unless, of course, the FP is an extraordinarily gifted physician (they do exist).
