One Pagers | Aug 15, 2012
The American Board of Family Medicine Young Leaders Advisory Group
Amidst sweeping changes to health care in the 1960s, the broadly influential Folsom Commission report, Health is a Community Affair, never fully achieved its vision of galvanizing the creation of Communities of Solution, which were empowered to improve health at the local level. Passage of health care reform, and persistent concern over poor health outcomes despite runaway spending, contemporizes Folsom’s call for nationally supported and evaluated, but community-driven, solutions to the nation’s health care challenges.
By the late 1960s, in the wake of rapid advances in medical technology and increased medical costs despite widespread unmet needs, the efficient provision of health services had moved to the forefront of national attention. In response, Eastman-Kodak Chief Executive Officer Marion Folsom and 32 prominent commissioners representing medicine, business, health advocacy, and government spent three years researching health service needs in 21 selected communities across the United States. The Folsom Commission report, Health Is a Community Affair, recommended a wide range of reforms, including the delivery of community health services in Communities of Solution rather than by political jurisdiction, the provision of every individual with a personal physician as the central integration point for every patient’s medical services, volunteer action, and community-level action planning.1
Although it is clear that the Folsom report stimulated many positive changes and influenced the formation of family medicine as a discipline, its vision of effective community action to improve health was never fully realized. However, with a current reform act that includes community-centric opportunities such as the formation of Accountable Care Organizations, patient-centered medical home pilots, and a Medicare Center for Innovation, the time is right for policy makers, primary care advocates, and public health leaders to revisit and revitalize Communities of Solution.2
We propose an updated list of Grand Challenges required to meet Folsom’s vision in a new era of health reform:
The American Board of Family Medicine Young Leaders Advisory Group (“The Folsom Group”): Andrew Bazemore, MD, MPH, The Robert Graham Center for Policy Studies in Family Medicine and Primary Care; Sean P. David, MD, SM, DPhil, Stanford University School of Medicine; Marguerite Duane, MD, MHA, Georgetown University School of Medicine; Kimberly Griswold, MD, MPH, University at Buffalo SUNY School of Medicine and Biomedical Sciences; Sarah Lesko MD, MPH, Seattle, Washington; Thomas Morgan, MD, Vanderbilt School of Medicine; John M. Westfall, MD, MPH, University of Colorado School of Medicine; Larry Green, MD, University of Colorado School of Medicine and The American Board of Family Medicine; James Puffer, MD, The American Board of Family Medicine; Betsy Garrett, MD, University of Missouri School of Medicine.
The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.
Published in American Family Physician, Aug 15, 2012. Am Fam Physician. 2012;86(4):online. This series is coordinated by Sumi Sexton, MD, AFP Associate Medical Editor.