In July 1966, the Duke University School of Medicine established a new department: the Department of Community Health Sciences. Its roots were multiple and complex, and began with a decision to discontinue another department — the Department of Preventive Medicine — which had functioned since the first days of the medical school.
The Department of Community Health Sciences (renamed Community and Family Medicine in 1979) has long been described as a “catch all,” a department that took in divisions and programs that didn’t belong anywhere else in the medical center.
July 2016 marked the 50th anniversary of the department’s founding, and through the years the seemingly mismatched programs and divisions have worked together toward one common goal: improving the health of people in their communities, whether at home, at work or in the local community.
Origins of the Department
A 1975 document from the Duke University Medical Center Archives states that “Duke was found to be an unfriendly environment for the development of a family medicine program as the department began in 1966. This matter was again discussed in 1970, and the faculty again did not favor the addition of a family physician training program at that time.”
E. Harvey Estes, Jr., distinguished service professor emeritus and former chair, said that the other clinical department chairmen suggested that instead of a family medicine department, they could create a department that looked at sociology, economics, teams and computers. Thus, the Department of Community Health Sciences began in July 1966.
Duke Physician Assistant Program History
The Duke Physician Assistant Program celebrated its 50th anniversary in October 2015, marking the milestone of being the first physician assistant (PA) program in the nation and the birthplace of the PA profession.
The Duke PA program originated in the Department of Medicine, but moved to the Department of Community Health Sciences (later renamed the Department of Community and Family Medicine) two years later.
Occupational and Environmental Medicine History
For more than 30 years, the Duke Division of Occupational and Environmental Medicine (OEM) within the Department of Community and Family Medicine has been committed to improving the health of working populations. The division began with a vision by Leonard Goldwater, M.D., who began working at Duke University Medical Center in 1968. Goldwater was a well-recognized occupational health specialist who received a medical degree in 1928 from the New York University College of Medicine, then known as University and Bellevue Hospital College of Medicine. After World War II he became a professor of industrial hygiene at the Columbia University College of Physicians and Surgeons.
Community Health History
The impetus to improve health care for the Durham community skyrocketed when the Division of Community Health became a full-fledged clinical division of Duke University Medical Center on July 1, 1998. This academic group has gained prominence on the national stage by showcasing how it excels in analyzing population needs, designing interventions, testing them and disseminating knowledge. Though 45 collaborative, community-based clinical, care management, education and research initiatives across seven state counties form quite a track record, the team isn’t resting on its laurels.
Family Medicine History
In the spring of 1985, the fate of the Department of Community and Family Medicine was in question after William Anlyan, M.D., then-chancellor of health affairs for Duke University, made the announcement that all clinical operations of the department would be phased out, including the family medicine clinical practice and residency program.
What followed was a very public struggle between Duke University Medical Center, Durham County General Hospital, family physicians from across the nation, Duke medical students and alumni, and national family medicine organizations. It wasn’t the first time the department had to fight for family medicine, though, and it wouldn’t be the last.
Department's Role in Population Health Training
A two-part series examines the department's role in helping the university, the state, and the nation adapt to the changing face of health care.