In July 1997, the AAFP Board of Directors approved the development of a "Center for Policy Studies in Family Practice and Primary Care" to be located in Washington, DC. It was envisioned that the Center would be responsible for research and analysis to inform deliberations of the Academy in its public policy work and to provide a family medicine perspective to policy deliberations in Washington, D.C.. The proposal for the Center stated:
"The Center would be focused on important policy questions related to family physician services and the general domain of primary care, and would seek to marshal arguments regarding the importance of such services, and prepare rebuttal analyses to proposals and initiatives which would appear to inhibit or limit the ability of clinicians in the primary care area to provide services effectively."
From its inception, it was decided that the Center’s activity would be a blend of research to support the Academy’s policy development and advocacy efforts and Center-initiated studies. The proposal stated that the Center would have a "degree of intellectual autonomy and independence" comparable to that of the Editor and Editorial Advisory Committee of the American Family Physician journal. The Center was to be purposefully located in Washington, D.C., in close proximity to the Academy’s Washington office to facilitate interaction of staff.
In the summer of 1999, Larry Green, MD, was hired as the founding Director, who along with Lisa Klein, the Center’s administrative assistant, and Ed Fryer, PhD, its first analyst, comprised the Center's initial staff. They were joined later that year by a second analyst, Susan Dovey, PhD, MPH, from Dunedin, New Zealand. The Center was organized around three initial themes: the functional domain (scope of practice), primary care infrastructures, and universal health coverage. Within just two months of its inception, the Center began its commitment to training a new generation of physician-researchers by launching an internship program. Drs. Green and Fryer published a declarative description of the Center, "The Development and Goals of the AAFP Center for Policy Studies in Family Practice and Primary Care", in the Journal of Family Practice in 1999, and the first research products were published in HealthCare Paper in December of that same year. In its first six years, the Center produced 80 peer-reviewed publications, two book chapters, five monographs, and 29 one-pagers.
In 2000 the Center was renamed, The Robert Graham Center: Policy Studies in Family Medicine and Primary Care, in honor of the former Executive Vice President of the AAFP, Robert Graham, MD, who had envisioned the formation of the Center nearly a decade earlier.
In 2000, an assistant director was hired. The Graham Center was expanded in 2004 with the addition of an economist and administrative support.
The Center also established formal academic and research relationships in Washington, D.C. With Georgetown University, this meant faculty appointments and research support for the family medicine department. Thanks to the vision of its chairman, Dr. Jay Siwek, this relationship also produced a health policy fellowship. There are also sustaining relationships with the George Washington University School of Public Health, the U.S. Agency for Healthcare Research and Quality, the National Center for Primary Care at Morehouse University, practice-based research networks in Washington, D.C., and Virginia, and with community health center networks in Washington, D.C., and Baltimore. These are just a few of many collaborative relationships that have expanded the capacity and work of the Graham Center and which represent its commitment to supporting primary care research capacity.