I would like to thank the authors and the Task Force on Physician Supply for the balanced and reasoned position paper on the role of the future general internist [1]. I offer one additional thought for the consideration of the College's leadership.

In years past, the nation's general practitioners decided that they needed to redefine themselves to receive the respect that they deserved; as a result, the specialty of family practice was born. These practitioners developed standards of residency training, a board examination, and academy fellowships to establish that their members were actively specialized in general practice, not just passively lacking specialization.

General internal medicine is now in a similar position. At least in our community, most general internists have had more general medicine training than their subspecialty colleagues, and many subspecialists have lost much of the competence they may have once had in general medicine.

Perhaps it is time that we consider formalizing general internal medicine as a recognized subspecialty, requiring additional training (possibly including, for example, more dermatology, neurology, and psychiatry than other subspecialists need) and offering separate board examinations. With such an approach, the field would gain stature and become a more appealing choice to medi-cal students. This approach would also underscore the fact that many of us really are specialized in general medicine and are better at it than those who have specialized in other areas.