The 2003 Curtis G. Hames Research Award in Family Medicine was presented to Paul Nutting, MD, MSPH, from Denver, Colo, at the Society of Teachers of Family Medicine Annual Conference held September 20–24, 2003, in Atlanta. Dr. Nutting has contributed greatly as a tireless champion of research and scholarly endeavor in family medicine and as a researcher and scholar himself.
The Curtis G. Hames Research Award in Family Medicine is presented each year to honor those persons whose careers exemplify dedication to research in family medicine. The award also honors Curtis Hames, a community-based physician, researcher, and long-time clinical faculty member of the Department of Family Medicine of the Medical College of Georgia. Dr. Hames has been recognized internationally as a pioneer in family medicine research. The winner each year is chosen by a committee of representatives from STFM, AAFP, and NAPCRG based on career achievement both in his or her own research accomplishments and in facilitating the research of others.
In a recent interview with Dr. Nutting for this article, several key threads emerged that have intertwined throughout his research career. First, he has consistently focused on research attempting to capture the naturalistic environment in which patients receive care. Second, clinical and research lessons learned early in his career convinced him of the value of a population-based, prospective approach to health care. And third, Dr. Nutting has worked to assist primary care practices in their efforts to reengineer to improve quality of care.
These threads all emerge repeatedly and consistently in reviewing Dr. Nutting’s career. He began his research career during his years with the Indian Health Service after he completed a pediatric internship. While in the Indian Health Service, he found a rich laboratory for exploring concepts of a population-based approach within a community and target population that was very well defined and with health care services that were organized around the community. His growing interest in population-based research led him to complete a preventive medicine residency. An early study testing a community intervention for childhood gastroenteritis taught him that it is possible to identify specific individuals at risk in the community and that simple community interventions could have an important effect. Another study testing an intervention to improve processes of prenatal care for women with high-risk pregnancies, however, proved to him the difficulty of reaching a high-risk population and showed him that even a well-intentioned and well-conceived program might inadvertently reduce care to the targeted group.
After 12 years with the Indian Health Service, Dr. Nutting was chosen to serve as the study director for the Institute of Medicine Community-Oriented Primary Care (COPC) project, and he moved to Washington for the first time. During that project, time spent with Curtis Hames, Maurice Wood, Larry Green, and others exposed him to the intellectual firepower within family medicine. Dr. Nutting remembered meeting Dr. Hames for the first time, arriving at his office about a week after starting the COPC project and finding that Dr. Hames had been waiting for him since 6 am to discuss the project. Dr. Nutting indicated that Dr. Hames’ ideas really came to life in his practice, and observing Dr. Hames helped give Dr. Nutting the faith that the COPC principles which had worked in the Indian Health Service could also be applied in other types of practices.
As they worked together on the COPC project, Maurice Wood repeatedly told Dr. Nutting that he needed to supplement his pediatric internship and preventive medicine residency with a family practice residency so he could solidify his credentials as a generalist. This advice fell on receptive ears. Dr. Nutting had increasingly found that family medicine fit well with his ideas about and approach to health care. So, Dr. Nutting turned 40, got married, started his family medicine residency, and had his first child during an intense 18-month period. Upon completing his residency, he rejoined the Indian Health Service for a year before returning to Washington as the director of the Division of Primary Care for the fledgling Agency for Health Care Policy and Research (AHCPR).
Upon retiring from the Public Health Service after several years at AHCPR, Dr. Nutting considered a variety of possible positions before deciding that his primary focus should be on research and taking the job as executive director of the Ambulatory Sentinel Practice Network (ASPN). The years at ASPN were highly rewarding as ASPN was able to move primary care research in new breakthrough directions. The list of studies accomplished by the network throughout this period is impressive. Dr. Nutting was especially proud that ASPN was able to serve as both a model and a rallying point for many other, smaller networks.
Since the unfortunate demise of ASPN in 1999, Dr. Nutting has been focusing on research that brings together most of the themes in his earlier work. The primary focus of his current work is on assisting practices in redesign efforts to provide higher quality care for patients with chronic disease. This work has particularly capitalized on lessons learned from his past research that have demonstrated the systemic nature of medical practice.
In addition to his groundbreaking research, Dr. Nutting has contributed greatly to family medicine research capacity building. For many years he chaired the North American Primary Care Research Group’s Committee on Building Capacity. His years as editor of The Journal of Family Practice showed him the need for and potential viability of a journal focused on family medicine research. He has served as a mentor for countless family medicine researchers, both formally through the Grant Generating Project and informally. His capacity-building and mentorship efforts were recognized through a President’s Recognition Award from the North American Primary Care Research Group in 2002.
The Hames award is intended to recognize those who have contributed to family medicine research either directly as a researcher or indirectly by promoting research within our discipline. Paul Nutting’s major contributions in both of these areas made it very easy for the Hames Award Committee to decide to recognize him with the 2003 Curtis G. Hames Research Award in Family Medicine.
- © 2003 Annals of Family Medicine, Inc.