• Robert Graham Center Is Vital Tool for Family Medicine

    "I may not live to see our glory. But I will gladly join the fight. And when our children tell our story, they'll tell the story of tonight."
    -- Lin-Manuel Miranda

    This week, the United States of America celebrates its 242nd birthday. Our "great experiment" in democracy has faced its share of challenges. It has fulfilled dreams, overcome adversity, stared down evil and, at times, failed to live up to the expectations set forth by our founders. Yet it stands, a country built by generations of diverse people who left their ancestral homes and traveled across continents and oceans to reach our shores in search of a better tomorrow for themselves and their families. E pluribus unum. May we all forever strive for a better tomorrow.  

    Speaking of birthdays, the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care (RGC) celebrated its 19th on June 23. Originally called the Center for Policy Studies in Family Practice and Primary Care, the Center was established by the AAFP Board of Directors in July 1997 and began operating two years later. The AAFP Board envisioned a research entity that would promote the value of family medicine and primary care more broadly in public policy debates. A proposal said the center "would be focused on important policy questions related to family physician services and the general domain of primary care, and would seek to marshal arguments regarding the importance of such services, and prepare rebuttal analyses to proposals and initiatives which would appear to inhibit or limit the ability of clinicians in the primary care area to provide services effectively."

    The Center officially began operations in June 1999 under the direction of Larry Green, M.D. That year, Green published a declarative description of the Center, The Development and Goals of the AAFP Center for Policy Studies in Family Practice and Primary Care, in The Journal of Family Practice. His article set forth the vision and mission of the Center and, as they say, the rest is history.

    In 2000, the Center was renamed the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in honor of former AAFP EVP Robert Graham, M.D.

    Today, the RGC's vision statement reads: "The Robert Graham Center for Policy Studies in Family Medicine and Primary Care exists to improve individual and population health by enhancing the delivery of primary care."

    To achieve this vision, the Robert Graham Center

    • conducts and publishes research on issues that impact primary care;
    • disseminates data that enable policymakers to bring family medicine and primary care perspectives to health policy deliberations at the local, state and international levels;
    • provides analysis on issues that affect primary care, including payment, workforce, infrastructure and needs assessment;
    • applies research and geospatial mapping to determine trends in the supply, training, distribution and location of the primary care workforce, as well as other health care resources;
    • establishes partnerships with individuals and institutions to conduct and support primary care research and to expand the capacity for such research;
    • tests the impact of policy solutions; and
    • grows its primary care economic portfolio.

    Under the leadership of Andrew Bazemore, M.D., M.P.H., since 2012, the RGC team consists of family physicians as well as a variety of social scientists, ranging from sociologists to geographers to economists. During the past 19 years, the RGC has grown into a nationally recognized research entity and is one of the nation's most respected voices on issues related to primary care. It counts among its collaborators the federal government, state governments, other foundations, universities, Fortune 100 companies and of course, family medicine organizations across the nation.

    The RGC has published hundreds of papers, policy briefs, and one-pagers during its 19 years. You can access these on the publications and reports portion of the RGC website.  

    Have you ever asked yourself, "How many family physicians practice in rural communities?" or, "How many family physicians deliver babies?" If yes, look no further: The RGC recently published The State of Primary Care in the United States: A Chartbook of Facts and Statistics. This document is a treasure trove of data, findings and just interesting factoids about primary care and family medicine.

    One of my favorite products produced by the RGC continues to be the Ecology of Medical Care (Section 2.1 of the chartbook). This analysis shows that primary care is the largest platform of formal health care in the United States.

    "Using multiple data sources and comparing primary care services to other medical specialty services, the model showed that more people seek primary care than any other type of health care service," notes the chartbook. For every 1,000 people in the United States,

    • 800 report symptoms;
    • 327 consider seeking medical care;
    • 217 visit a physician's office (of which 113 visit a primary care physician);
    • 65 visit a complementary or alternative medical care provider;
    • 21 visit a hospital-based outpatient clinic;
    • 14 receive health services at home;
    • 13 visit an emergency department;
    • eight are hospitalized; and
    • less than one person is hospitalized in an academic medical center.

    To add some perspective, the odds of the University of Texas winning the Big 12 football championship are higher than the odds that any given American will receive care in an academic medicine center, but both are extremely low.

    Happy Fourth of July!  


    Stephanie Quinn, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.  Read author bio »


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