Challenges for Family Medicine and for Family Physicians

To the Editor: One of the challenges for family medicine and for family physicians who are committed to research and publishing is that our discipline, more than almost any other, is practice-based. Unlike many medical and surgical subspecialties, we were not born in a laboratory. Following this line of logic, it is clear that much of the research that attempts to answer important questions in family medicine must be done in our community-based practices. This reality creates a dilemma, because most trained and experienced researchers and writers in family medicine are based in medical schools or residencies, not in the real-world practice sites that could help answer our questions.

Several approaches have been successfully used to deal with the frequently encountered mismatch in location between practice-oriented family physicians and research-oriented family physicians. One of the best known approaches has been the regional (or national) research network, in which a large number of practices have been linked to an academic center (or network hub), to address problems in an organized fashion. The recent Edwards and Norris article1 illustrates another solution to the same problem. In this case, an inquisitive rural family physician in full-time practice contacted his regional medical school (Idaho is a participant in the University of Washington’s affiliated family practice residency network) seeking a collaborator. Once the right “match” was made, the community practice was able to provide the data, and the medical school faculty member was able to assist with research design, data analysis, and writing. This sort of partnership has great potential in linking the community practice-based and the academic center-based members of our specialty. It offers a powerful model to assist in answering important practical “real-world” questions.