According to researchers, the family may be changing but it is still one of the central institutions in society. Studies report a shift in more than 20 attitudes and values, most of which relate to the context of family life. Specifically, these include attitudes toward marriage, divorce, childbearing, childrearing, working women, family violence, female/male household roles, and parental obligation to children. Reports also indicate that many children prefer television to their own parents. The cumulative effect of these changes has not brought happiness or "self-fulfillment." At least three areas need to be addressed: (1) the contemporary image of the family as a restrictive and uncreative environment, (2) the professional and bureaucratic structures with which we have encircled the family, and (3) the need to evolve a new image of the family to preserve continuity and change. As a backdrop to these changes, the Framingham study, a 30-year investigation that has established factors connected to coronary heart disease, is of interest. While this investigation did not address psychological and social data as factors, medical practice should consider data resulting from it in terms of assumptions about causes of disease, the connections between disease and human relationships, consideration of familial life in health problems, and close physician contact with families. Reformation of medicine in light of familial principles should result in a reduced scale of operations, simple principles, lower costs, and rebuilt human exchange. (BJD)