Given the chorus of approval for primary care emanating from every party to the health reform debate, one might suppose that the future for primary physicians is bright. Yet this is far from certain. And when one looks to history and recognizes that primary care medicine has failed virtually every conceivable market test in recent years, its prognosis is--to use doctor jargon--"guarded" at best. Primary care careers do not appeal much to today's American medical students. General practitioners, sensing both a loss of status and not wanting to be left behind professionally, began renaming themselves family practitioners and extending their own residency training after medical school to equal that of the internists. Naturally, this blurred the difference between the two groups of doctors and added to the difficulty of defining what is meant by "primary care." The entry of nurse practitioners only added to the confusion. These uncertainties contribute to the sinking status of primary care medicine. In this article, the author talks about primary care's dim prognosis and focuses on the negative aspects of primary care since they help explain the difficult predicament for primary physicians and for those thinking of a career in primary care. The author suggests that, if government and insurance carriers believe that patients need reminders to have evidence-based health screening, they should send them out directly. He stresses that the public health role of primary physicians must be reexamined. The author also suggests that primary care physicians must be allowed to work more sensibly than they are now and provides a real-life example.