ABSTRACT
The US is a young nation born out of pioneers and with philosophies of equality of opportunities, freedom and democracy, self-reliance and entrepreneurship - all of which have been transmitted into the health care system. The modern American health care system arose from a wide range of therapies practiced by large numbers of healers in the late 19th century. After years of campaigning, general practice attained specialty status by requiring residency training and board certification centered on its new focus, family practice. Family physicians and general internists represent the largest groups to whom people turn for primary care. The US spends the most money on health care yet registers the highest consumer dissatisfaction with their medical care of any industrialized nation. The manpower crisis of the late 1960s precipitated a major federal program to expand medical schools. In fact, much of the 'crisis' stemmed from there being too few generalists and too many specialists.
