Family practice as a specialty, now just over 20 years of age, arose in response to increasing public pressure and societal needs, not primarily from a breakthrough in new clinical knowledge or technology advances. Its academic discipline of family medicine is necessarily derived more from its clinical principles and functions in practice than from a unique body of knowledge and skills. Nevertheless, the mixture of knowledge, skills, and attitudes are collectively unique as applied by the family physician, and are teachable, learnable, and subject to critical inquiry and research. This paper presents an overview of the progress, present challenges, and future opportunities of family medicine as an academic discipline. A comparative analysis of the literature in the three primary care specialties reveals more commonalities than differences. Family practice has much to contribute to needed reforms in medical education and the health care system. The field is ideally positioned to be an active part of future resolutions to today's problems in both arenas.