Arthur Kaufman, MD, 2008 Farley Lecturer, Speaks to DFM about Community Medicine

Incorporating community medicine and public health into the teaching and practice of primary care was the focus of the 2008 Eugene and Linda Farley Lecture.

The lecture was presented on September 9, 2008, by Arthur Kaufman, MD, vice president for community health at the University of New Mexico (UNM) School of Medicine.

Farley Lecture

Dr. Kaufman's lecture, entitled "Integrating the Health of the Public into the Education and Service Mission of the Academic Health Center," began with an overview and explanation of the looming national primary care workforce crisis.

He discussed some of the specific primary care delivery challenges faced by New Mexico, a state where 30 of its 33 counties are designated as full or partial Health Professional Shortage Areas (HPSAs).

Dr. Kaufman briefly chronicled 30 years of primary care education and service innovations at the UNM School of Medicine. These innovations began in 1979 with changes to the school's preclinical curriculum, and continue through to the present with the evolving integration of public health and primary care.

"We need to go beyond educational reform to address the realities of modern medicine," Dr. Kaufman said in his lecture. "Our health care system is not organized to address the reality of the problems we face."

Dr. Kaufman presented three major ways the UNM School of Medicine is addressing this problem:

1. First, the school is committed to training all of its students in public health. Medical students matriculating in 2010 and thereafter will earn a 17-credit certificate in public health in addition to their medical degree.

"This may be the skill set our graduates use in practice to improve the health of their communities beyond the high-quality care they give to their individual patients," Dr. Kaufman commented.

2. Second, the school has implemented a set of community health service models designed to respond to community priorities. These include one-stop shopping clinics, called "health commons," a 24-hour, statewide nurse-staffed health advice line, and a primary care dispatch program linking the uninsured to medical homes.

3. Third, the school established an Office of Community Health, which serves as a mechanism for it to receive important feedback from communities about their priority health needs and the barriers they face, and to devise ways to address them.

The Office has also created numerous Health Extension Rural Offices (HEROs) throughout the state to build full-time University presence in communities while building local capacity to address health problems.

The community engagement initiatives taking place at UNM share common goals with those at the UW School of Medicine and Public Health (SMPH). During his visit, Dr. Kaufman met with several SMPH leaders who are working to make similar changes in Wisconsin.

"Both schools are committed to community engagement of their health centers," he said. "With UW's new title as a School of Medicine and Public Health, UW and the University of New Mexico will be taking leading roles nationally in the integration of the two fields of medicine and public health.

The fact that neither institution has a school of public health will reduce silos and facilitate the diffusion of concepts and practices of public health across the education, service, and research missions of UW and UNM."

» Watch archived video of the Farley lecture

Statewide Grand Rounds

Earlier that afternoon, Dr. Kaufman also made a presentation via videoconference at the Department of Family Medicine's statewide grand rounds.

The presentation, entitled "Introducing Community Medicine into Family Medicine Education and Practice," echoed many similar themes as the Farley Lecture.

Dr. Kaufman began by defining community-based learning as a way to achieve educational relevance to community needs. "If the community is the learning environment," he said, "then the definition of a teacher is broader."

He also introduced the concept of "new vital signs," such as job security, adequate housing, and adverse childhood experiences, that play a significant role in the health of an individual... or a community.

Dr. Kaufman then outlined the approaches UNM has taken to integrate community medicine principles into residents' experiences and into clinical practice. He also discussed strategies for overcoming institutional barriers to introducing population health in medical education.

He concluded the presentation by pointing to the need for new partnerships between educational institutions, health systems, and communities, and explained how these partnerships can make an impact on local economic and community development.

» Watch archived video of the Statewide Grand Rounds presentation

About Dr. Kaufman

Dr. Kaufman is an internationally respected leader in community and family medicine and medical education. He is the former director of the Rockefeller Foundation-funded Health of the Public program, which was instrumental in bringing public health into medical education.

He was also the director of the New Mexico World Health Organization Collaborating Center for the Dissemination of Community-Oriented Problem-Based Education.

Dr. Kaufman has also won the Humanism Award and Primary Care Award from the AAMC, and numerous awards from the STFM and AAFP local academies.

About the Farley Lecture

Established in 1993, the Eugene and Linda Farley Lecture stimulates ideas and discussion through visits by select candidates. It was named after Eugene Farley, MD, one of the recognized founders of the specialty of family medicine and DFM chair from 1982-1992. Dr. Farley has been a life-long activist for social responsibility and the health of underserved populations.