AUGUSTA -- When a succession of reports assessing the United States' healthcare system came out in the 1960s, they each lodged a similar complaint: The breed of the general medical practitioner was disappearing in the United States.

"Everybody was training as a specialist," Dr. Alex McPhedran said recently at the practice he helped found, Family Medicine Institute, or FMI. "I was part of that."

But McPhedran, who earned a neurology degree from Harvard Medical School, recognized a need for the primary care doctor and, in the early 1970s, he teamed up with Warren Kessler, now a retired head of MaineGeneral Health, to found FMI.

The family practice, which opened its doors in 1973, was the first of its kind in central Maine and, McPhedran estimated, among the first 10 percent of similar practices in the United States. The American Medical Association, after all, had only officially recognized "family practice" as a specialty in 1969.

This year, the practice, with offices in Augusta and Fairfield, celebrates its 35th anniversary as a patient-care facility and a training program for budding family physicians. A family practice treats patients of all ages -- the whole family, in essence -- rather than focusing on specialized types of treatment for specialized groups.

"What it is now is something that at the beginning, none of us could have envisioned," McPhedran said of the practice. "At the beginning, we were an add-on with an uncertain future."

But with time, FMI has become a fixture in the central Maine medical community. The practice was even the subject of the 1984 book "Heirs of General Practice," by Pulitzer Prize winner John McPhee.

Specialty medical fields today still hold a special allure -- namely higher pay and more regular hours -- for recent medical school graduates. But family practice holds an appeal of its own.

"I like the idea of taking care of an entire family, and I like the fact that no two days are similar," said Katje Musgrave, one of ten residents nearing the end of their first year as FMI residents.

Musgrave, originally of Wichita Falls, Texas, became a resident in the practice's Fairfield office after earning her Doctor of Osteopathic Medicine degree at the University of New England College of Osteopathic Medicine. FMI has partnerships with the University of New England degree program, Darmouth Medical School and MaineGeneral Medical Center.

McPhedran estimates "hundreds" of doctors have graduated FMI's residency program since its founding. Many come from overseas to work toward certification in the United States.

"It can be a stepping stone," McPhedran said. "We've learned so much from the very diverse group we've had."

One of the earliest FMI graduates finished the training program in 1975 and became a dermatologist in Pennsylvania. Some graduates have returned to the research lab. And one graduate served as the chief of medicine at Togus.

Others have remained interested in family practice, despite the demands on their time.

"If you're doing primary care, you have to be available yourself or have some other way of being covered," McPhedran said. "That makes some people reluctant to do primary care."

At FMI, McPhedran and the other teaching doctors urge their trainees to work in groups.

"It's hard to survive with your sanity if you don't," he said.

Dr. John Woytowicz estimated the practice handles 30,000 medical visits each year.

"We see ourselves as having a mission to the community," Woytowicz said, "and that's all the community."

The practice and the medical field have undergone major changes since 1973. A new office building in Augusta has helped the practice better handle its caseload, McPhedran said. New technologies have transformed the way doctors work.

One essential of medical care, however, has not changed.

"We really have to learn how to relate to (patients)," McPhedran said.

And the teaching doctors need to relate well to their students.

"You definitely feel like you can grow as a physician, and you're learning from some of the best we've got here in Maine," Musgrave, the resident, said.

In his retirement, McPhedran works with the FMI residents approximately 10 hours each week. The FMI environment, he said, needs to be one designed to encourage a new generation of family practitioners.

"They never feel they're going to be put down," he said. "The atmosphere in this place is really good."

Matthew Stone -- 623-3811, Ext. 435

mstone@centralmaine.com