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Research ArticleArticles

The Research Domain of Family Medicine

Larry A. Green
The Annals of Family Medicine May 2004, 2 (suppl 2) S23-S29; DOI: https://doi.org/10.1370/afm.147
Larry A. Green
MD
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  • Figure 1.
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    Figure 1.

    The ecology of medical care revisited.

    Note: All numbers refer to discrete individual persons and whether or not they received care in each setting in a typical month.

    From: Green LA, Fryer GE Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001;344:2021–2025.10 Reprinted with permission from the Massachusetts Medical Society. Copyright© 2001 Massachusetts Medical Society. All rights reserved.

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    Figure 2.

    Generalist wheel of knowledge, understanding, and inquiry.

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    Table 1.

    Ways of Knowing and Seeking Medical Knowledge

    Inner RealityOuter Reality
    Individual Quadrant 1 Quadrant 4
    Type of knowledge“I” knowledge“It” knowledge
    WhyUnderstanding the clinician is essential to family practice, since in part “the doctor is the drug”Understanding that natural phenomena and interventions to affect them comprise the biological basis of medical practices
    WhatKnowledge of the clinicianDisease-specific knowledge of clinical phenomena
    HowSelf-reflection, journalingObservation, epidemiology, experimentation
    WhoReflective cliniciansDetached observers
    WherePracticePeople or parts of people
    Collective Quadrant 2 Quadrant 3
    Type of knowledge“We” knowledge“It” knowledge
    WhyThe voices of patients, families, and communities are central to the goals and effectiveness of family practiceFamily practice operates within a systems context, which must be understood to enhance its effectiveness
    WhatKnowledge of the patient in contextSystems knowledge
    HowParticipatory researchHealth services research
    WhoParticipant observersHealth services researchers
    WhereCommunity or practiceHealth care system
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The Annals of Family Medicine: 2 (suppl 2)
The Annals of Family Medicine: 2 (suppl 2)
Vol. 2, Issue suppl 2
1 May 2004
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The Research Domain of Family Medicine
Larry A. Green
The Annals of Family Medicine May 2004, 2 (suppl 2) S23-S29; DOI: 10.1370/afm.147

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The Research Domain of Family Medicine
Larry A. Green
The Annals of Family Medicine May 2004, 2 (suppl 2) S23-S29; DOI: 10.1370/afm.147
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  • Article
    • Abstract
    • INTRODUCTION
    • THE ECOLOGY OF MEDICAL CARE
    • THE REALM OF CAUSATION
    • KNOWING MEDICINE IN DIFFERENT WAYS
    • THE NATURE OF THE WORK OF FAMILY PHYSICIANS
    • CATEGORIES RESEARCHERS LIKE TO USE
    • THE WHEEL OF KNOWLEDGE
    • FURTHER COMMENTS
    • CONCLUSION
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