Family Physician Proposes New NIH Agency

August 18, 2010 -- Despite the surging demand for primary care physicians, the supply limps along. And there’s no shortage of ideas for closing the gap. They range from capping academic specialty programs to loan forgiveness when graduates choose to practice as generalists. 

 

Dr. Douglas E. Peterson has come up with a novel approach -- one he believes will make the practice of family medicine more attractive to prospective doctors. 

 

He wants the National Institutes of Health, the U.S. government’s medical research agency, to create an Institute of Family and Community Medicine to elevate the profile of family physicians and enhance collaboration among research scientists.

 

This concept actually could get off the ground. Peterson’s been asked by the American Association for the Advancement of Science (AAAS) to submit his proposal to the Obama Administration’s Office of Science and Technology Policy in Washington DC. The Office asked experts to submit “Grand Challenges,” the difficult problems whose solution should become a national priority. Sequencing the human genome was once considered a Grand Challenge.

 

Peterson also sent his proposal to Senators Wyden and Merkeley and is awaiting a response.

 

“My father always said that common problems are common—found everywhere,” Peterson said. “Because of this, family medicine is very rewarding but medical students don’t see it as such.” 

 

Family medicine is a major factor in reducing and holding steady the rapidly growing cost of healthcare in this country, he said. A scarcity of general physicians means that people with insurance may have to go to the hospital emergency room, which is more expensive. A family physician could have treated them, but many practices have reached capacity and aren’t accepting new patients. 

 

When patients are directed to a burgeoning number of specialists and sub-specialists, their care is fragmented. They often find the whole world of medicine so confusing they don’t know where to turn. To Peterson, “It’s like having car trouble. You don’t look for an automotive specialist. You want an experienced general mechanic who can tell you how to fix it.”

 

A generalist in medicine approach can provide that guidance. Better yet, it’s cost effective in many ways, according to a list of medical sources compiled by Dr. Fred Matthies. An advocate, gadfly, and Fellow with the American Academy of Family Physicians, Matthies addresses what he calls “a surfeit of specialty physicians.”

 

He compiled chronological references from a variety of sources to demonstrate “just how long some well-seasoned and respected folks have been advocating for more family physicians.” The citations begin in 1966 and continue through 2008.

 

The list concludes with a position paper from the American College of Physicians. “Within the United States, states with more primary care physicians per capita have better health outcomes…increased quality of health services, as well as a reduction in costs…” (Annals Intern Med 148: 1, 2008.)

 

Peterson hopes to improve the number of generalists practicing in Oregon by at least one. He’s looking for a practice here after leaving Florida, where he voluntarily surrendered his license after a complicated confrontation with that state’s medical board. His decision ended an escalating series of fines for a single disputed care incident that occurred in 1999.

 

A family physician who spent 15 years working in Florida, Peterson is an emeritus member of the AAAS and former senior medical advisor with the U.S. Department of State.