ON ROUNDS | FALL 2016
BY LESLIE ZGANJAR
This year marks the 50th anniversary of Meeting the Challenge of Family Practice, a report prepared by the Ad Hoc Committee on Education for Family Practice of the Council on Medical Education, established in 1964 by the American Medical Association. Dr. William R. Willard, founding dean of CCHS, chaired the committee, which held 13 two-day meetings in the two years leading to the 1966 release of the report. At the time, experts were calling for the need for physicians to provide continuing, comprehensive health care. The report gave rise to the specialty of family practice (now family medicine), and highlighted the need for physicians to understand the impact communities have on health and the importance of providing care in communities.
Communities have a significant bearing on the health of their residents, and because of that, care should be integrated into communities. These were among the fundamental findings of the 1966 report, Meeting the Challenge of Family Practice, known today simply as the Willard Report.
The report gave rise to the new discipline of family medicine, and it provided a focus on the importance of and the need for another new field—community medicine.
“The physician … is knowledgeable about organs and systems, and techniques, but never forgets that organs and systems are part of a whole man, that the whole man lives in a complex social setting, and that diagnosis or treatment of a part, as if it existed in isolation, often overlooks major causative factors and therapeutic opportunities,” according to the report. “The patient’s problems should be viewed in context of … factors in the community. Physicians should understand the economic and psychosocial barriers to medical care faced by many patients.”
This was a radical notion at the time, “the opening of a field called community medicine” with the concept that communities play a role in health and that patient care should be provided in communities, says Dr. David Mathews, former University of Alabama president who was instrumental in the creation of the College of Community Health Sciences.
“And community medicine, or community health, said you don’t just treat individuals, you have to take the whole community into consideration,” says Mathews, who later served as secretary of the US Department of Health, Education and Welfare. “This was early on when we didn’t fully appreciate what we know now, which is the high correlation between the characteristics of a community and the health of the people who live there.”