Family medicine is the predominant provider of primary health care in the United States, yet it receives relatively little research funding from the National Institutes of Health (NIH). Family medicine can help the NIH speed research discovery and improve research relevance; the NIH can help family medicine build its research capacity, and such mutual benefit could mean improvement in public health.
Sean C. Lucan, MD, MPH, MS; Andrew W. Bazemore, MD, MPH; Imam Xierali, PhD; Robert L. Phillips JR., MD, MSPH; Stephen Petterson, PhD; and Bridget Teevan, MS
The NIH is the federal agency whose mission is to conduct and support biomedical research; its objectives are “to extend healthy life and reduce the burdens of illness and disability.”1 In family medicine practices, physicians and patients come together with the same objectives nearly 250 million times every year—more times than in any other medical specialty's practices.2
Despite shared objectives, the NIH and family medicine seldom interact. Of the $95.3 billion total the NIH awarded in research grants from 2002 to 2006 (which includes three years after the NIH budget doubled), family medicine received slightly more than $186 million—only about two pennies for every $10 (see accompanying figure).3 Nearly 75 percent of all grants to family medicine came from only six of the NIH's 24 funding institutes and centers, and one third of the institutes and centers did not award any grants to family medicine.3
Figure: NIH Grants to Family Medicine Compared with Other Specialties
Little engagement between family medicine and the NIH represents missed opportunity. Family medicine has insufficient funding to develop its research capacity, and the NIH has poor capacity to translate research into improved population health. New government funding may improve these situations by fostering engagement between family medicine and the NIH.
The American Recovery and Reinvestment Act added $8.2 billion to the NIH coffers and created new research priorities,4 all consistent with the interests of family medicine. Family medicine is embedded in communities across the country, and with greater NIH investment, family medicine can mobilize well-established community and practice-based research networks, put persons to work, and speed the translation of scientific progress into community contexts, improving population health. The NIH should seize on expansions of its budget and priorities to partner with family medicine.