Unfinished Business: The Role of Research in Family Medicine

Gotler's history of the development of research in family medicine - and really primary care as well - relates to my own experience that in the first 15-20 years after the beginning of family medicine education, education was the obvious focus and research, over subsequent years, had to gain traction and credibility from both the practicing and the academic communities. Family medicine was emerging from a bruising time both internally (who are we? How do we define ourselves?) and externally (General practice as an academic discipline. Reflections after a visit to the United States. McWhinney IR.Lancet. 1966 Feb 19;1(7434):419-23.) and the challenge was to gain a foothold in the health systems in the US.

As Gotler outlines, that changed with the addition of fellowships, departmental research programs, and investments by the practicing community in research centers such as the Robert Graham Center. Now research is an essential component to every academic department and residents are encouraged to take on scholarly projects and practice improvement - aligning the clinical and scholarly missions of family medicine - is the focus of national meetings and interdisciplinary research.

However, 15 years ago a study described how an expression of interest in research selected against interest in family medicine (Factors related to the choice of family medicine: a reassessment and literature review.Senf JH, Campos-Outcalt D, Kutob R.J Am Board Fam Pract. 2003 Nov- Dec;16(6):502-12.) which may or may not have changed, according to Gotler's history. Family Medicine and primary care need to appeal to student interest in research even more than other disciplines. "The best and most demanding research is done here" should be on the banner of every Department in the country. Future research will shape the improvements in health in this country and those improvements will be most necessary in the realm of primary care, community health, and the quality, costs and benefits of community based care.

Competing interests: None declared