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     Background.  

WHAT’S IN A NAME?

On June 14, 2005 the Department of Family Practice & Community Medicine officially became the Department of Family and Community Medicine by vote of the UK Board of Trustees. This change reflects the growing complexity of the research, educational mission, and service interests of the Department as well as the diversity of our faculty members.

Community medicine has an early tradition at the University of Kentucky. The first department of community medicine in the United States was founded here in the early 1960’s by Dr. Kurt Deuschle. Dr. Deuschle and the Department became well known worldwide for the revolutionary concepts introduced in medical education and research. In addition to the usual courses in epidemiology and biostatistics, medical students participated in some of the first-ever community preceptorships with practicing physicians. They also studied community health problems by a formalized process of a community diagnosis. Elective international clerkships were offered to selected fourth-year students to increase their skills in primary care, and carry out original research projects in their host countries. The concept of integrating the study of the community in the context of the clinical practice of medicine is a legacy we hope to maintain by the inclusion of “community” in our title.

Family medicine as a discipline also has historical roots at the University of Kentucky. Dr. William Willard, the founding dean and vice-president of the College of Medicine, was the chair of the AMA Committee that produced the Willard Report, one of the seminal position papers, which led to the establishment of family practice as a new discipline. One of the faculty members in that period was Dr. Nicholas Pisacano, a general practitioner who not only had a great influence on the Willard report, but also became one of the founders of the American Board of Family Practice and served as its first executive director. The first home of the Board was in the UK College of Medicine.

It is in this context that we wish to further and preserve our original mission of the department, while at the same time, recognize the diverse nature of our research, clinical and educational mission to address community health needs and concerns in a broader sense. We also honor the memories of such outstanding leaders such as Doctors Pisacano, Deuschle, and Willard who contributed so much to American medicine. We look forward to our new role and its responsibilities.

Source:  U.K. Family & Community Medicine Newsletter Issue Number 1

 
   
     Timeline:  
  1. The Early Years: 1930, 1941, 1947-1948, 1956, 1959 
          (Click here to open & close a description of the history.)
    1. 1930 GP accounted for 80% of all physicians
         
      1941

      In 1941 when a delegate to the American Medical Association (AMA) House of Delegates called for a certifying board in general practice, it was not yet time for this idea. In fact, 28 years would pass before the twentieth primary specialty board would be approved.
      http://www.afprd.org/afprdtext/historyidentify.html

         
      1947-
      1948

      1947 The Davis-Truman Special Committee of the American Medical Association (AMA) studied conditions of general practice; this was just the first of several committees that would examine various aspects of the issue over the next 20 years; ABGP holds first meeting; 1948-1st residency programs in general practice were developed; Kentucky Chapter holds its first meeting (called Kentucky Academy of General Practitioners)
      http://www.afprd.org/afprdtext/historyidentify.html http://www.kafp.org/x2678.html

         
      1956

      Kentucky Legislature acted on recommendation from Governor A.B. Chandler to create a medical school at the University of Kentucky.

      May 1956 UK Board of Trustees authorizes establishment of medical center to include: medicine, dentistry, nursing, student health, medical library and university hospital.

      University of Kentucky College of Medicine begins under direction of its founding Dean: Dr. William Willard (1956-1965) (Source: “A Medical School is Born”)
       

         
      1959

      In 1948 residencies in general practice began to develop, and pilot residencies in family practice were set up in 1959; 1959-1st pilot family practice residency programs began and KAGP office is in Louisville
      http://www.afprd.org/afprdtext/historyidentify.html

 
  1. The Development Years for specialty & at UK: Fall 1960, 1960s, 1965,
          1966, 1969, late 1969   (Click here to open & close a description of the history.)
    1. Fall of 1960

      UK College of Medicine 1st medical class (40 students); becomes 86th medical school in the United States and one of 40 new schools developed since WWII.
      (Source: “A Medical School is Born”)
       

         
      1960s Graduating class of UKCOM includes notable graduates such as:
               Dr. Samuel Matheny (Chair, Department)
               Dr. Emery Wilson (Dean, COM 1987 til 2004)

      Faculty teaching at UKCOM includes notable physicians such as:
              Dr. Nicholas Pisacano: The American Board of Family

              Practice (ABFP) established the Pisacano Leadership

              Foundation in 1990-91 to honor Nicholas J. Pisacano, M.D.,

              founder and first executive director of the ABFP, Lexington,

              KY

              Dr. Claire Louise Caudill: Dr. Caudill was instrumental in       

              bringing improved healthcare to Morehead with the start of St.

              Claire Regional Medical Center
               www.st-claire.org/Site/Physicians%20Corner/beginnings1.html

      First Department of Community Medicine ever offered in a medical school started under direction of Dr. Kurt Deuschle (1960-1968) who was selected by the college’s Dean, Dr. William Williard. (Source: “A Medical School is Born”)

      By the 1960s, the general public was also becoming aware of what this specialization meant to them as patients. It was increasingly difficult to find a physician to be a continuous, comprehensive provider of medical care.
      http://www.afprd.org/afprdtext/historyidentify.html

         
      1965

      By 1965, after repeatedly voting down resolutions to create a certifying board, the Congress of Delegates of the Academy voted to authorize application for a certifying board. Once committees delineated the core content for the residency curriculum and the “Special Requirements for Residency Training in Family Practice,” the stage was set.
      http://www.afprd.org/afprdtext/historyidentify.html

         
      1966 Three social reports on peoples’ frustration with the healthcare system called for a new medical specialty of family practice to meet people’s perceived needs in a fragmented healthcare system:

      The graduate education of physicians: report of the Citizens Commission on Graduate Medical Education (Millis Commission)

      Meeting the challenge of family practice: report of the American Medical Association. Ad Hoc Committee on Education for Family Practice (Willard Committee).

      Health is a community affair: report of the National Commission on Community Health Services (Folsom Commission).

      All called for a new medical specialty of family practice to meet people’s perceived needs in a fragmented healthcare system
      http://www.futurefamilymed.org/PreBuilt/5 & the slides from “1. FFM Background”

      The 1966 Report of the Citizens Commission on Graduate Medical Education, entitled “The Graduate Education of Physicians” and commonly called the Millis Report, emphasized the fragmentation in patient care that was occurring. To maintain their skills and knowledge, physicians were being trained to care for only a portion of a patient’s health. Few were being trained for comprehensive and ongoing care.
      http://www.afprd.org/afprdtext/historyidentify.html

         
      1969

      Finally, following approval by the Liaison Committee for Specialty Boards, the Advisory Board for Medical Specialties, and the AMA Council on Medical Education, the American Board of Family Practice, Inc. (ABFP) was incorporated on February 8, 1969.
      http://www.afprd.org/afprdtext/historyidentify.html;

      AMA recognizes family practice as a specialty http://www.kafp.org/x2678.html;

      ABFP is incorporated with Dr. Nicholas Piscano as founder and executive director-first meeting held in Lexington, Kentucky. http://www.aafp.org/fpr/970100fr/4.html

         
      Late in 1969

      Within a few months of the approval for the American Board of Family Practice, 20 residency programs had been approved by the AMA Council on Medical Education. These programs had met the “Special Requirements for Residency Training in Family Practice” that had been approved in December 1968. These “essentials,” as they were commonly known, described a three-year program that covered family medicine, internal medicine, pediatrics, psychiatry, obstetrics and gynecology, surgery, and community medicine. This later was considered to be one of the unique components of family practice.
      http://www.afprd.org/afprdtext/historyspecialty.html;

      1969 58,000 General Practitioners & 0 Family Physicians

      2000 15,000 General Practitioners & 70,000 Family Physicians
      http://www.futurefamilymed.org/x19624.html & the slides from “1. FFM Background”

 
  1. Family Medicine in Kentucky/Nation Continues: 1971, 1975, 1988-1989,
         1991, 1999, 2000-2001, July 2003, & into the present
         (Click here to open & close a description of the history.)
    1. 1971        AAGP officially becomes AAFP offering the nation’s 20th medical specialty http://www.aafp.org/fpr/970100fr/4.html;

      Trover Foundation Family Practice Residency Program, Madisonville begins; first of its kind in Kentucky (http://www.mc.uky.edu/RuralHealth/recent/WhitePaper.pdf, page 5)

         
      1975

      Department of Family Practice receives full accreditation for its family practice residency at UK and graduates its first class of 4 residents; since then we have had 196 graduates. (Source: Janice Thomas, Residency Program Coordinator)

         
      1988 -1989

      At the University of Kentucky, our family practice program, in conjunction with the ABFP, developed and pioneered the nations’ first Accelerated Residency Program (Source: Janice Thomas, Residency Program Coordinator  & www.mc.uky.edu/familypractice/pr/accelerated_residencies.html)
       

      1991

      The East Kentucky Family Practice Residency Program (housed at the University of Kentucky Center for Rural Health, Hazard) begins accepting residency applicants
      (http://www.mc.uky.edu/RuralHealth/recent/WhitePaper.pdf, pg. 5)

         
      1996 -1997

      Dr. Samuel Matheny endowed the “Dr. C. Louise Caudill Chair of Family Medicine”

         
      1999

      Department of Family Practice receives full accreditation to offer a Sports Fellowship program [Janice Thomas]

         
      2000-2001

      2000 University of Kentucky Rural Family Practice Residency, Morehead receives full accreditation; the first residents arrive in 2001 with graduates expected in 2004
      (http://www.mc.uky.edu/RuralHealth/recent/WhitePaper.pdf, page 6 & Janice Thomas, Residency Program Coordinator)

         
      July 2003

      Dr. Samuel Matheny named Dr. Nicholas J. Pisacano Chair of Family Medicine

         
      June 2004 The Department of Family Practice becomes the Department of Family & Community Medicine with approval from the University of Kentucky Board of Trustees.
Faculty at the University of Kentucky Department of Family & Community Medicine are deeply involved in the current trends for the specialty and improving access to care within the state. For more information, please check out your local and national family practice organizations such as:

AAFP http://www.aafp.org/
The Robert Graham Center http://www.aafppolicy.org/
ABFP https://www.abfp.org/index.aspx
STFM http://www.stfm.org/index_ex.html
KAFP http://www.kafp.org/
Future of Family Medicine Project: http://www.futurefamilymed.org/
 
 

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  Sources: Future of Family Medicine ProjectAAFP
                  The Kentucky Academy of Family Physicians

                   History of the University of Kentucky, College of Medicine:
                   “A Medical School is Born” [ISBN 0913383481]
 
 
     Useful Links~  

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Quick Facts on Kentucky
Economic Development Information System
Kentucky Atlas & Gazetteer
U.S. Census Bureau for Kentucky
Medically Underserved Areas/Populations: Kentucky
Healthy Kentuckians 2010
State Health Facts Online
Health Professional Shortage Areas
Health Kentucky
Health Status of Kentuckians - 1999 Requires Adobe Acrobat Reader (opens in new window)
Kentucky Festivals
Why Family Practice?
Why is PC/FP important to the health of America?
Rural Kentucky's Physician Shortage White Paper (opens in new window)
Family Practice - What you need to know
Getting Involved In Your Academy
Professional Organizations
AAFP
American Medical Association
Society of Teachers of Family Medicine
Kentucky Academy of Family Physicians
North American Primary Care Research Group
Resident & Student Websites
AAFP Student Membership
Association of American Medical Colleges (AAMC)
Kentucky Academy of Family Physicians
Virtual Family Medicine Interest Group
CareerMD
Databases & Online Journals
Medical School Libraries Online
National Library of Medicine (PubMed & MedLine)
UK Medical Center Library
JAMA
Student JAMA
New England Journal of Medicine
Family Practice
  NOTE: Accessing some of these journals might require registering for access. Check with the UKMC library for access rights/privileges as a medical student to these and more. UKCOM library website http://www.mc.uky.edu/medlibrary/
Internet Guides for Medical Topics
Doctors Guide to the Internet
Primary Care Internet Guide
Family Doctor
US Department of Health & Human Services
AAFP Health Education Programs for Patients
Government Organizations
Research

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WARNING: Some Web sites to which these materials provide links for the convenience of users are not managed by the University of Kentucky. The University does not review, control, or take responsibility for the contents of those sites. 

 

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