The DFM: Celebrating a Rich History of 35 Years

Join me in celebrating 35 years of the Department of Family Medicine! Our accomplishments are many and notable over the years. For example:

• We have trained 972 Family Medicine graduates who practice throughout the State of Wisconsin and the nation, in rural, urban, and underserved areas.
• We are ranked by the 2006 Edition of the US News and World Report as the 5th best Family Medicine program in the country.
• We are building one of the largest National Institutes of Health (NIH) research programs in the country. The Institute has noted the UW-DFM as 5th in total NIH grant awards. Our Department currently has more than 50 funded federal and non-federal grants.

Our success and national reputation is a credit to our faculty, residents, fellows and staff who have been a part of the DFM over our 35-year history.

Our Department has a rich history. We honor Marc Hansen, MD as the visionary and founder of our Department, who continues to work with us, providing in recent years, the inspiration and expertise for our Clinical Data Warehouse. Following are a few excerpts from an interview I had with him about the beginnings of the DFM:

John Frey, MD: "I would love to hear the story..."

Marc Hansen, MD: "Well, actually, I was never the Director of the Program, but I was the creator of the application that led to the Program. It really started with what I wanted to do when I left medical school, which was a fairly unusual way to leave Harvard. I was going to take a year of Medicine; I was going to take a year of Pediatrics, and practice General Practice... what became a primary care idea..."

"I spent two very busy pediatric clinical years in the army, spent two years in the Enzyme Institute, actually set up a lab, but realized I was clearly not doing what I was either interested in or good at, and took on the task of recruiting someone to be the replacement for a faculty member who had run a well baby clinic... I recruited myself, and said what we really need is a clinic that is, what became a primary care idea. I started that within a relatively short time. ... We added obstetrics and medicine over the next couple of years... and we had a family health service. We were in fact delivering family services in that model..."

"I was told, 'You're doing everything except training family physicians.' So we wrote up our expectation of how a program would get put together for training family physicians and submitted it... By that time I'd raised enough money from the State to have the beginning of a planning program to expand what we were doing and add the family physician model to it, and I set about negotiating with the local community hospitals...and selected one particular hospital where most of my family practice colleagues were most comfortable. And we recruited John Renner as the initial Program Director and the first residents came. John came in '70 and the first residents came in '71."

"I don't remember whether in the legislation we used explicitly the words 'Primary Care', but it supported both family practice development and the continuing development of our multi-doctor/nurse/therapist model."

"...there was a tremendous pressure to get doctors out there. ...And when the first legislator appeared on our door, a guy by the name of Tommy Thompson [former Wisconsin governor and US Secretary of Health and Human Services] from Elroy...I gave him this impassioned, academically oriented system story about what we were trying to do and why... We got the planning money."

"I was the main internal doer... and had some community partners. And the institution itself wasn't ready at all. It was a much simpler institution than it subsequently became with the continued elaboration of sub-specialization... the kind of arguments that we used to have were about what we were trying to do and why the system needed generalists in the communities -- exactly the same kind of things we're still talking about."

"I think the best of general practice has always been Family Practice... I much later maintained my clinical role more actively in family work than I did in pediatrics; ...I always stayed as a pediatric teacher and did clinical work, but what I really enjoyed doing was family work."

John Frey, MD: "...what are the kinds of things you had anticipated would happen, did happen, and some things you thought would happen that didn't happen?"

Marc Hansen, MD: "My...staying in the same place for a long time deepens but narrows your perspective. ...It's amazing how similar in some ways the existing Department is relative to what I would have imagined it would be... It is clearly the community. It is clearly in the State. It's kind of gradually become more the Medical School, which I would have hoped for, and it's taken as long and been as difficult as I would have guessed in the beginning. But it's been well-paced in the sense that at the point they were ready... we were ready to deliver."

"...What I probably didn't anticipate as much...is the gradual sub-specialization of Family Medicine, which has certainly been a dramatic part of our particular departmental evolution..."

"...Well, one of the interesting things, you're part of the generation that's the illustration of what I am driving at, is that the earliest recruits to training in Family Practice, I think, were adventurers. They really were a part of a counterculture. They understood that if it was going to work, they were going to have to help make it work."

John Frey, MD: "I describe my residency experience to residents now, and they can't believe that I actually got accredited."

Marc Hansen, MD: "Probably wasn't accredited for all I know... but the net result was that it did succeed in creating the next generation of leaders."

John Frey, MD: "What are your concerns about the next generation or generations coming along?"

Marc Hansen, MD: "...Certainly the needs of the system for practitioners are as acute now as they were in the earliest days, and the political dialogue about that has become as active as it was then..."

John Frey, MD: "...there is some kind of image that people carry in their minds about what a good doctor is, and that generally comes from an experience or an observation that has to do with the qualities of the physician relating just to you generally, or to someone, ...with kindness and compassion and all those things. And that's the image of a lot of people who go into Family Medicine--that is to somehow recreate that physician in themselves in some way."

Marc Hansen, MD: "Probably on top of an even deeper type, that has to do with what a good person is."

We are certainly grateful to Marc Hansen, MD for his vision for Family Medicine in the early days, and to the physicians from the community who worked with him and others to make the residency and Department a reality. Marc's tireless energy and commitment to the Department continues with him remaining an active Emeritus Professor and still working in the DFM. To all who helped him build the UW-Department of Family Medicine, thank you. With many accomplishments, dedicated faculty, innovative research and scholarly work, cutting edge teaching, high quality care to over 25 communities throughout the State, inquisitive and successful residents and fellows, and committed staff, we have come far in the 35 years since our beginning, and yet have much more to do.