The Department of Family Medicine is a relatively new member of the Divisional community, created in 2000 and beginning full operation in 2002 with the appointment of Bernard Ewigman, M.D., as Professor and Chairman. The department was created in response to the fact that the University of Chicago was one of only a few medical schools that did not have a Department of Family Medicine, a situation that can be partly attributed to the basic research-intensive atmosphere in the division. In the early 1990s, there was increased interest in starting such a department in order to help provide medical students with appropriate training in family medicine, as it is considered to be one of six core disciplines in medicine, along with internal medicine, pediatrics, obstetrics & gynecology, surgery, and psychiatry.

“In order to address the needs of the medical students, the University established an affiliation with MacNeal Hospital, located in the southwest Chicagoland area,” explains Ewigman. “When MacNeal Hospital became a for-profit institution, those profits were channeled into the MacNeal Health Foundation, which then approached the University about financing a Department of Family Medicine.”

“The idea was that the MacNeal Residency Program at MacNeal Hospital, which has 36 residents, 3 fellows and 11 faculty, would be the clinical and teaching campus of the department, while administrative and research space would be maintained at the University Medical Center,” Ewigman continues.

Family medicine is different from many specialization in the field in that it is not limited by age or organ or procedure, but rather addresses the prevention and treatment of common and serious conditions in the population at large.

“There are several major differences between traditional family practitioners and modern family physicians,” says Ewigman. “Family physicians consult and refer more frequently and get extensive training in every other major specialty in medicine. They have to be well-versed in treating the whole patient, not just a single part.”

The department’s main aim is the education of students through the clerkship, which requires third year medical students at the Pritzker School of Medicine to have a third year clerkship experience in family medicine, and also through the teaching of the Clinical Epidemiology course. Additionally, there are a number of electives that have been created for those students interested in entering the field of family medicine as a specialty.

“Family medicine was the first specialty to require resident physicians to spend three years of training both with their own patience and their own practice, seeing patients under the supervision of the attending family physicians, and to spend intensive time training under the supervision of other specialist attending physicians, such as general and subspecialty internists, pediatricians, psychiatrists, orthopedist, gynecologists, and so on, “ explains Ewigman. “Family physicians must become experts in common, acute, chronic and emergency problems as well as in preventative medicine.”

The second aim of the department is to build research programs that are national in scope and to train academic family physicians for research careers. These research topics include the diagnosis, management and treatment of common clinical conditions, as well as preventive health services. The department has two initiatives in the Hispanic community, which is the majority of the population surrounding MacNeal Hospital. One of these initiatives involves the development of a curriculum to teach language skills and cultural competence to physicians entering largely Hispanic communities. The second initiative addresses the needs of Latin American diabetics who have different medical needs for the management of their condition.

Dr. Ewigman is also involved in a grant lead by David Meltzer, M.D., Medicine, to look at preferences and outcomes of management of diabetics in Hispanic, African American and Caucasian communities.

“This grant aims to examine the differences in the ways patients of different racial and ethnic communities respond to the traditional approaches to the treatment of diabetes,” says Ewigman. “Our department is different from family medicine departments in other institutions in that it is so research-oriented. We have several inter-disciplinary research efforts in place that help bridge the gap between basic research and patient care.” Ewigman and his faculty are also well positioned to partner with Cancer Research Center efforts to strengthen population-based research.

The third aim is developing innovative ways of delivering primary care services, particularly in the area surrounding MacNeal Hospital. This includes creating practices that serve not only to care for patients but also to teach students and residents, and allow for research in a practice-based setting.

“We want to use information technology to translate research to practice and to generate research from practice,” Ewigman says. “Family medicine by its nature is interdisciplinary and often has links to not only other clinical departments but also social sciences and public health departments. Our department’s goal is to bring all of those groups together to the benefit of our patients.”

The department's academic faculty currently consists of Dr. Ewigman and John Hickner, M.D., Professor, who joined the department in 2003 after 25 years at Michigan State University College of Human Medicine (MSU-CHM) where he was Professor and Associate Chair for Research in the Department of family Practice.

 

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