Family Health Science and the New Generalist
Practitioner
ROBERT C. LIKE, M.D., M.S.t
MARY B. BRECKENRIDGE, Ph.D.f
DAVID E. SWEE, M.D.t
JOSEPH A. LIEBERMAN, III, M.D., M.P.H.*
In this article, we respond to calls for
educational reform in the health profes-
sions by proposing that the discipline of
Family Health Science should serve as the
"basic science" of generalist practice, by
which we mean such fields as family
practice, general internal medicine, gen-
eral pediatrics, family dentistry, family
nursing, and family nutrition, to name a
few. Specifically, we argue for the formal
inclusion of the subject of family health
science in health professions educational
programs. First, we discuss the relevance
of a family systems perspective for both
clinical and public health practice. Sec-
ond, we briefly review the nature and scope
of Family Health Science research and
scholarship. Third, we describe our innova-
tive Family Health Track educational
program in the New Jersey Graduate
Program in Public Health, which is de-
signed to train generalist health profession-
als who can work at the interface between
clinical practice, public health, and health
care policy. Finally, we examine some of
t Department of Family Medicine, UMDNJ-Robert
Wood Johnson Medical School, New Brunswick NJ.
Address reprint requests to Dr. Like at the Depart-
ment of Family Medicine, UMDNJ-Robert Wood
Johnson Medical School, 1 Robert Wood Johnson
Place, New Brunswick NJ 08903-0019.
t Department of Family and Community Medicine,
Medical Center of Delaware, Wilmington DE.
the current proposals being made to "heal
the schism" between medical and public
health education (47), and suggest that the
creation of Family Health Science Educa-
tional Pathways may help both to bridge
this gap and to produce the next generation
of primary care physicians and generalist
health care practitioners.
Fam SystMed 11:149-161,1993
Just as Flexner identified a model and helped
us get out of an ill-fitting box at the turn of
the century[,] . . . health professional schools
must now entertain a new vision of what they
should be. This vision must include a richer
array of academic disciplines, a more interac-
tive relationship with the community and
public, a more integrated connection to the
practice side of the profession, a greater
openness to education and work across the
health professions and a greater willingness
to experiment with alternative structures for
organizing the work of education, research,
and patient care. [38, p. 12]
T
HE Pew Health Professions Commis-
sion has recently proposed an "action
agenda" that would lead to the education
of health care professionals who could help
meet the "National Health Promotion and
Disease Prevention Objectives" for the
Year 2000 and beyond (16). The impor-
tance of promoting primary care and
149
Family Systems Medicine, Vol. 11, No. 2, 1993 © FP, Inc.
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