History of Family Medicine
Since colonial times in the United States, medicine has been divided into three distinct groups: the physician, the surgeon, and the apothecary. Physicians were viewed as elite and usually held a university degree. Surgeons, in contrast, were typically apprenticed and hospital trained. This distinction between medicine and surgery did not survive in colonial America. Physicians were in America were expected to also perform surgery and prepare medicines. This was the beginning of the general physician in the United States.
The emergence of specialization within American medicine did not take root until the middle of the 19th century. As the base of knowledge within medicine continued to grow and many doctors chose to do more of what they were interested in and good at, specialization became inevitable. The role of the general physician remained an essential part of health care in the United States, however. By the early 1900s many states required candidates for medical licensure, including the general physician, to have a 1-year internship in a hospital setting in addition to possessing a medical degree.
Following WWII, the number of specialties and subspecialists increased at a phenomenal rate, while the number of general practitioners declined dramatically. However, the public became increasingly vocal about the fragmentation of their care and the shortage of personal physicians who could provide initial, continuing and comprehensive care. The concept of the generalist was reborn with the establishment of Family Practice as medicine’s twentieth specialty in February, 1969. Rather than training being limited to one year of post-graduate training, it was increased to three years.
History of the Family Medicine Department at Creighton University
One year later, in 1970, Creighton University School of Medicine established the Family Practice Division of the Department of Preventive Medicine, headed by Dr. Michael J. Haller, MD. In August of that same year, an approved program began for training residents in family medicine. A Family Practice Clinic was opened at 3374 South 13th Street in Omaha which was staffed by residents and which served not only to help alleviate the shortage of primary care physicians, but also as a developing ground for the new specialty of Family Practice.
In June 1971 a “Pilot program” was begin with Creighton interns at St. Joseph Hospital. Dr. Michael Haller, MD, established a program of airplane flight instruction for interns and residents in order to make practice in a rural community more attractive. He believed that faster mobility to larger cities would increase the desirability of rural community medicine and may help alleviate the rural physician shortage in Nebraska and other Midwestern states. Creighton was the only medical school in the country to have such a program.
In 1973, the Division of Family Practice went on to become a Department in its own right.
During the 1970’s the Family Practice Department expanded its operations to include “model units” at three locations throughout Omaha (28th and Ames, 13th and Deer Park Blvd, and 50th and Grover Streets) which simulated the structure and functioning of a private family practice office for the training of its residents.
In 1973 the School of Medicine was one of only five medical centers nationwide to receive a $10,000 Health Maintenance Organization (HMO) planning grant from the Association of American Medical Colleges. This grant was to help determine how HMO’s could relate to academic medical centers. Dr. Michael Haller of the Family Practice Department was instrumental in helping to determine the feasibility of HMO’s at Creighton.
On December 11, 1977, the new St. Joseph Hospital, now known as Creighton University Medical Center, was officially opened to the public and the former St. Joseph Hospital on 10th and Martha was closed.
In 1980 the Department of Family Practice became affiliated with the Student Health Center of Creighton University.
Throughout the 1980’s efforts were made by the Department of Family Medicine to reach out to minority high school students to create more interest in medical careers. As reported by Dr. Diane Dodendorf in 1987:
“Four minority high school students will receive hands-on experience in medical research as part of a summer apprentice program offered by the School of Medicine’s Family Practice Department. During the eight-week apprenticeships, students will help care for and collect data on patients suffering from hypertension. In addition, the students will attend Health Sciences classes and complete reading assignments. The apprentice’s work will be supervised by health care professionals.
The program is open to minority students currently enrolled as sophomores, juniors, or seniors from Omaha area high schools. Apprentices will work 30 hours per week at $3.40 per hour. A grant to fund this program came from the National Institute of Health.”
A Century of Teaching and Healing: The first one hundred years of the Creighton University School of Medicine, Carolyn Boro, BS, and Beverly Mead, MD, Creighton University School of Medicine, 1991, p. 296.
Erling Bergquist
We had a close relationship with the Family Medicine program at Ehrling Bergquist between 1982 and 1992 at which time the Ehrling Bergquist residency program was moved to UNMC (for the start of the 1992-1993 academic year). During the course of the 10 years, 22 Ehrling Bergquist residents graduated from our program. While we no longer work with the Ehrling Bergquist residents at Creighton University, our department has remained committed to the men and women of the Strategic Air Command Base and provided physicians to care for their servicemen and women, as well as their families, during the Gulf War in 1999 and 2000.
Charles Drew Health Center
In 1998, our residency program entered into an affiliation with Charles Drew Health Center, located at 29th and Grant Streets in North Omaha. Charles Drew was created to address the health care needs of the patient population who may be unable to afford health insurance in the North Omaha Community. Our residents were able to see patients at the Charles Drew Clinic and our patient numbers increased significantly. However, due to a desire to have our own Family Practice Clinic, Dr. Judson Jones initiated the development of a Family Practice Center at our Florence Clinic where our residents would be able to work along-side our own faculty members. The move was completed in July of 2003. While our location was changed to another part of North Omaha, our commitment to providing care for the poor continued in our new Family Practice Center.
Accelerated Residency Program
In June of 1991, the American Board of Family Medicine approved our program to participate in a pilot project to evaluate the concept of shortening the training cycle for Family Medicine by accepting senior medical students as first year Family Medicine Residents. This would allow the senior student the opportunity to simultaneously complete the senior year while fulfilling the requirements with the first year of Family Medicine Residency training. This program did not affect the graduation date from Medical School.
Since its inception, we have had 25 Creighton University medical students in the Family Medicine Residency Program. One prominent graduate of our program is Dr. Joann Schaefer (1994), Deputy Chief Medical Officer Health and Human Services, coordinating the state’s bioterrorism preparedness planning and readiness assessment efforts, and Chair of the Child Death Review Team.
Unfortunately, in 2003, the American Board of Family Medicine decided that 2004 would be the last year of all accelerated programs across the country. Our final two Accelerated Residents, Carrie Grady and Nicole Westfall, will graduate from Medical School in May of 2005.
Future of the Program
In July of 2004 we were notified by the Accreditation Council for Graduate Medical Education (ACGME) that we were placed on probation due to deficiencies in the program. We viewed this as an opportunity to make major revisions to the program and are excited about the changes that are taking place. Our program requirements have changed to reflect a more rigorous training program for our residents. In July 2005 we will implement a new 3-year core curriculum to both provide quality education and to systematically address all the new requirements by the Residency Review Committees (RRC). At this point, 90% of the citations have been addressed, and we will have 100% compliance within the next two months. The result of this process has been the development of a much stronger program. This was confirmed by our being taken off probation in May 2006 and given the maximum three years before the next accreditation visit.
We look forward to a bright future not only here at Creighton, but in having our graduates serve the medical needs of our patients throughout the world. Our Mission Statement is:
With a deep commitment to social justice in the Catholic, Jesuit tradition, the Department of Family Medicine will provide:
• Skilled and respectful education to our students, residents, physicians, and community
• Comprehensive and compassionate care to our patients
• Broad-based outreach to those in need and
• Scholastic excellence in all our endeavors.
We take this mission seriously and look forward to a bright future not only here at Creighton, but in having our graduates serve the medical needs of our patients throughout the world as representatives of Creighton and its Catholic, Jesuit heritage.
Key Dates and Facts about the Family Medicine Program at Creighton:
Chronology of Events
1969 – Family Practice Designated as a specialty following the tradition of the generalist.
1970 – Creighton University begins its Family Practice Residency Program.
1973 – Creighton University begins the Department of Family Practice.
1977 – St. Joseph Hospital is moved from 10th and Martha Streets to 601 North 30th Street.
1980 – Creighton University Student Health becomes affiliated with the Department of Family Practice.
1982 – Erling Bergquist Family Practice Program combines with the Creighton University Family Practice Program.
1991 – The American Board of Family Medicine approves our program participating in a pilot study accepting Accelerated Family Practice Residents.
1992 - Erling Bergquist Family Practice Program moves to UNMC.
1998 – The Department of Family Practice begins affiliation with Charles Drew Health Center in North Omaha and begins a Family Practice Center for the residents.
2003 – The Department of Family Practice ends its affiliation with Charles Drew Health Center and moves the Family Practice Center to the Florence Clinic in North Omaha.
2004 – The American Board of Family Medicine ends the Accelerated Family Practice Residency Program nationwide.
2004 – St. Joseph Hospital renamed Creighton University Medical Center.
2004 - The Department of Family Practice is renamed Family Medicine to reflect the name change by the American Board of Family Medicine.
Graduates
As of July 1, 2007, we boast 248 graduates with the following demographics:
42% Creighton University School of Medicine Graduates
31% US Medical School Graduates
27% Foreign Medical School Graduates
Department Chairmen
1973-1977: Mike Haller, MD
1977: Fred Pettid, MD
1978-1981: Mike Haller, MD
1984-1989: Eugene Barone, MD
1989-1995: Mike Haller, MD
1995-present: Donald Frey, MD
Department Program Directors
1970-1978: Mike Haller, MD
1978-1985: Fred Pettid, MD
1985-1991: Richard Hurd, MD
1991-1993: John Kuncaititis, MD
1993-1997: Donald Frey, MD
1997-1999: Jim Hougas, MD
1999-2001: Donald Frey, MD
2001-2004: Judson Jones, MD
2004-present: Donald Frey, MD
2004-present: Thomas J. Hansen, MD
