Securing for Academic Generalists the Opportunities and the Recognition that They Deserve

Excerpt

The proliferation of medical specialties and the exponential growth of Federal funding of basic science research coincided with the near extinction of generalist faculty from many medical schools after World War II. The renaissance of academic general medicine began in the 1970s, primarily in recognition of a need for ambulatory and inpatient general medicine teaching. Research programs grew around these clinical activities and included clinical epidemiology and decision-making, study of the clinical encounter, health services research and medical education. General pediatrics followed a similar trajectory. Family medicine grew as well, but with less emphasis on research, perhaps because the units were situated in departments without strong research traditions. Funding for generalist research has been challenging.1 NIH support varies dramatically by institute. The National Center for Health Services Research (now AHRQ) has supported such work, but funding has been intermittent, regularly threatened by congress and heavily influenced by political considerations. The Affordable Care Act opened important new funding streams, notably PCORI, but its future, with the prospect of ACA repeal, is highly questionable. …