The History of Research in Family Medicine in the United States
John J. Frey III MD
The University of Wisconsin School of Medicine and Public Health
Department of Family and Community Medicine

Family Medicine is a discipline which was intended to train replacements for a rapidly aging workforce of family doctors in the country, particularly in rural and urban underserved areas. The discipline officially began with the graduate training programs in 1969 and grew exponentially over the next 15 years from 16 residency programs to over 250. Programs began primarily in community hospitals that were loosely affiliated with medical schools. The growth of academic Departments of Family medicine was much slower. Medical schools were often not supportive of new Departments and did not fund them well.

The research infrastructure for family medicine was the last part of the discipline to develop. Ian McWhinney MD, one of the founders of family medicine in North America insisted in the 1970’s that there be a robust research program and training young investigators as a requirement to be an academic discipline. However it took another decade – until the late 1980’s – before there were sufficient fellowship trained faculty members who wanted sought a career in research and be competitive for funding from external sources such as NIH. The American Academy of Family Physicians invested in University research centers. National centers such as the Robert Graham center in Washington were also formed to engage in research which would inform public policy.  

has been the organization of primary care, the nature of clinical work and of clinical care in teams, and how best the fundamental principles of primary care – (1) person and family centered, (2) continuous, (3) comprehensive and equitable, (4) team based and collaborative, (5) coordinated and integrated, (6) accessible, and (7) high value – could be done successfully in populations in a US health system which has underfunded primary care for decades.

It has become quite clear that unless the financing of primary care in the US is changed to support primary care, the cost of health care will become unsustainable, health disparities will grow, and the entire health system will be in danger of collapse.