50 Years of Forward Thinking

In my office, I have a black medical bag. Given to its owner upon his graduation from the University in the 1930s, it went everywhere with him―always in readiness―to the end of his life. I keep it there because 1) it is fascinating, and 2) it reminds me of the level of commitment and service that this doctor and thousands of practitioners like him provided. Family Medicine and Community Health has carried forward this proud tradition for 50 years at the University of Minnesota.

In 1968, the University of Minnesota’s Board of Regents voted to approve a multi-step plan to expand and advance education for the health sciences. Step 1A was: “Develop a Department of Family Practice and Community Health. The Department will educate undergraduate medical students for family practice, provide residency training for physicians entering this specialty field, and explore new patterns for providing health care.”

And so it was, in 1969, shortly after the American Boards approved Family Practice as a new specialty, that our Medical School became one of the first in the nation to institute a Department of Family Medicine and Community Health (FMCH). And what a 50 years it has been!

Early in FMCH history, Jack Verby, MD, took the lead in developing the Rural Physicians Associate Program (RPAP), one of the first longitudinal integrated clerkships and a breakthrough model of placing trainees with community physicians. This (much copied) program resulted in high percentages of graduates staying in Minnesota and in improved access to healthcare across the state.

I recently spoke to Roger MacDonald, MD, who was an early preceptor for the RPAP program and whose experience provides an example of its success. Dr. MacDonald had a solo practice in and around Grand Marais for 13 exhausting years. He was joined by David Hilfiker, MD, a medical student in the RPAP program. When Dr. Hilfiker graduated, he returned to join Dr. MacDonald’s practice and even brought another young physician with him, Bill Gallea, MD. So the practice went from one physician to having three physicians very quickly. You can imagine the impact both on Dr. MacDonald’s quality of life and on the healthcare of the area. And, this was repeated over and over again throughout the state.

We see similar innovation in the program Renée Crichlow, MD, has started in North Minneapolis. The Ladder is a comprehensive mentorship and training program that supports connections among its members―from fourth grade students to attending physicians—as they work to improve community health, and to recruit and develop the healthcare providers of the future. And again, it is a model that evolved out of the needs of the community.

In 1977, FMCH brought the world-renowned Program in Sexual Health into the department, a program that remains cutting edge as it works to transform how we promote sexual health and view sexuality and gender. Health equity is the focus of both the Program in Health Disparities Research and HEAL (Healthy Eating Across the Lifespan).

Throughout its research, education, and clinical practice, FMCH is committed to ensuring that our communities receive the care and services they want and need. Nowhere is our mission of Community better served than by our Family Medicine educators, researchers, and practitioners. They provide continuity of care, a focus on preventative medicine and equitable access to care, and—in many communities—the close relationships that give people trust in the care that they receive, that their parents receive, and that their children receive.

The spirit of the family “doc” who carried the black bag lives on in our faculty, staff, and alumni of the department of Family Medicine and Community Health.

For 50 years of innovation and impact, congratulations!