The Origins of UW Family Medicine

		Dr. Theodore J. Phillips, founding chair of the UW Department of Family Medicine, in a photo taken while he was associate dean for academic affairs.

In 1967, Dr. Theodore Phillips searched in vain for a physician to join his solo family practice in Sitka, Alaska. When a former teacher visited to recruit Phillips into a new national movement promoting general practice within academic medicine, he had a ready argument:

“You just aren’t going to find physicians to do this kind of work,” he told Phillips, “unless people like you pick up the challenge to create academic programs in family practice.”

Two years later, Phillips met the challenge. After a year on the East Coast in one of the nation’s first family physician programs, he moved to the University of Washington as founding chair of the Department of Family Medicine.

It’s difficult to appreciate today that, until then general practice was, in academic terms, a kind of second-class doctoring. General practice had no residency requirement and no board certification. The longtime trend in medicine had been toward increasing specialization.

Forty years ago, few new GPs decided to enter rural practice. Northwest small towns such as Forks, Wash., and Tonasket, Wash., were unable to find doctors.

Dr. John Geyman, second chair of family medicine.

Phillips, now clinical professor emeritus of family medicine, and Dr. John Geyman, who succeeded Phillips as chair and is now professor emeritus of family medicine, played national roles in bringing general medicine back into high regard. They indelibly shaped the UW School of Medicine, where today approximately half the graduates are generalists.

In 1966, the Citizens’ Commission on Graduate Medical Education of the American Medical Association filed the Millis Report. Then UW President Charles Odegaard was a commission member. The report recommended establishing a new medical specialty devoted to general practice. A specialty for generalists is paradoxical. Nevertheless, the idea took hold nationally and internationally. In 1969, family practice became the 20th medical specialty. To be a family physician required three years of residency training after medical school, a certifying exam, and re-examination every six years.

At the UW, a curriculum pathway for family physician education was created. When Phillips arrived, he designed the curriculum, established residency programs, recruited faculty, and promoted clinical training in rural areas. His department grew rapidly. By 1971, half of the UW School of Medicine entering class was choosing the family practice pathway.

Geyman took over as chair in 1976. He consolidated Phillips’ work, expanded the faculty, and added a strong research element. Nationally, Geyman’s contribution was to ensure that family medicine developed a professional literature, and hence scientific respectability. He started the Journal of Family Practice, edited it for 17 years, and also edited the Journal of the American Board of Family Practice for 12 years.

In 2002, Geyman authored Health Care in America, and has another book, Falling Through the Safety Net: Americans Without Health Insurance, due out in 2003.

True to their principles, both doctors returned to rural practice before retirement. Geyman practiced for seven years in Friday Harbor on San Juan Island off the coast of Washington. Across the strait, Phillips practiced for six years on Lopez Island.

Many had doubted that the UW, a strong medical research institution, could ever shine brightly in primary care. Phillips and Geyman made it happen.