Obviously, you are likely to receive a broad variety of views in response to this question. From my own personal perspective, here are a few summarized thoughts:
Pros
Establishment of a truly caring involvement with one's patients and their families. In my experience, aside from FP, only pediatricians (and, as you likely know, peds is a significant component of FM), some primary-track IM and a few OB/GYN (also a notable component of FM) practitioners have the opportunity/desire to form such vital links in their patients' lives.
Procurement of skills facilitating care of all ages and most common presentations. Emphasis on less common conditions can be pursued by focused study (ie pursuit of specific training during residency, etc) and CME. Access to attaining abilities in endoscopy, colonoscopy, minor surgery, surgical OB and other procedures.
A broad, encompassing view of medicine and many sub-specialty disciplines.
Participating in the advancement of preventative medical practices within a given community. This is probably the most important means to prevent prevalence of debilitating, chronic illness among a defined population.
As an additional subjective observation related to the first point above. In my experience, the vast majority of family physicians truly CARE about their patients as individual precious personalities; as irreplaceable human beings. This is no longer common among many (not all) sub-specialists. I am admittedly biased on this one.
One practical consideration. As there are fewer people entering FM and the demand is increasing markedly, it is likely that opportunities in FM will increase in the near future (there are a very large number of current opportunites for many forms of practice such as outpatient only, I/P and O/P, hospitalist, occupational medicine, practice w/ and w/o OB, etc). The significant role in FM of peds, women's health and OB obviously allow a potential for a very wide variety of practice modalities.
Cons
Very limited access to fellowship training. This is largely limited to geriatrics, sports medicine, advanced hospitalist, OB and a few others. One may obtain "certificates" in derm, EM, etc. However, pragmatically, these aren't worth much. You can always peruse the offerings at the AAFP website. The reasons for a lack of access to GI, cards, rheum, ID, etc are specifically unclear. However, as I am actively trying to convince the powers that be that graduates of FM residency programs should absolutely have access to training in these fellowships, I feel that this is primarily political. Perhaps, with a few modifications in future FM residency program rotations, increased access to such training will materialize.
If you are interested in biomedical research, this is not an effective path. Research is limited to soft community-based projects. These certainly have importance, but will not satisfy a biomedical scientist (I speak from personal experience). Further, research funding is piddling. Again, this may change in the future.
Relevant to the research issue, academic credibility is limited and of narrow focus.
The compensation of a FP is among the lowest of all physicians (although potential for earning is very variable. Some FP earn a great deal of money!). This is slowly increasing and is likely to continue to improve in the near future.
One could also comment re the perceived and reported "lack of respect" afforded by other physicians. I won't comment on this (true or not) as I feel it is their problem. I feel it is a privilege to be a FP.
After all is said, IMHO I feel that the Pros far outweigh the Cons. Pursuing a career in ANY area of medicine is a very individual decision. Consider the Pros and Cons of any specialty in which you have interest. I hope the above has been of some help in regards to FM.
