Our Department has been part of the rich history which includes the development of social medicine and community health programs at Montefiore Medical Center (MMC) andAlbert Einstein College of Medicine (AECOM), a process which began in the mid-20th century. The Residency Program in Social Medicine (RPSM) began in 1970, and The Department of Family Medicine was first established at MMC in 1978 and at AECOM in 1992. The Department is a joint Department based both at MMC and AECOM, and the Unified Chairman is responsible for departmental activities at the medical school and the affiliated hospitals.Since its inception, the department has grown far beyond its original scope in clinical care, education, research, and community health activities.
Clinical programs and sites include: three affiliated community-based health centers which are our residency teaching sites, a 19-bed inpatient family medicine teaching unit, a large hospital based palliative care program, a wound care program and other specialized clinical service programs (e.g., health care for the homeless, outpatient HIV care, immigrant health services). Educational activities include residency training in family medicine, social pediatrics, and social internal medicine within the Residency Program in Social Medicine; undergraduate programs including a required medical student third-year clerkship and additional electives; and fellowship training in research, faculty development, and reproductive health care. Community health activities include education, outreach, and partnership with community-based organizations and institutions on issues related to health promotion and advocacy for the underserved.
The Department of Family and Social Medicine's over-riding goal has been to improve the health status of underserved populations through employment of a four-pronged strategy:
- To train primary care physicians to work in community-based health centers and other outpatient sites;
- To develop a model system of primary care for the urban underserved;
- To engage in original research relevant to the populations we serve; and
- To collaborate with community partners in advocacy, outreach, and services programs to help improve
community and population health in the Bronx and beyond.
Since 1970, the mechanism for addressing the first strategy has been the Residency Program in Social Medicine, a three-track program which prepares board-eligible residents in either family medicine, social internal medicine, or social pediatrics. This strategy has been very successful with over 90% of graduates remaining as generalists, about 75% taking their first job in practices serving inner city poor communities, and about 60% of all graduates still practicing in such sites.
The second strategy, developing a model of primary care for underserved inner-city communities, has been addressed through what originated in our Department as the Montefiore Ambulatory Care Network. This network is now operated through Montefiore’s Medical Group at a total of 21 community-based practices and health centers, including the three community-based sites which are our resident teaching and faculty practice sites, accounting together for over 350,000 visits per year.
With the advent of Family Medicine as an academic department at AECOM, resources became available to develop a Research Division. The focus of research has been on problems --- both clinical and health services --- that affect our target communities. The division has fostered an increased interest in research activities, provided mentoring to young faculty, and has been very successful in the generation and funding of research grant proposals. External grant funding for the Department, both through the Research Division and other investigators, has increased from a total of $2.1 million in 2000 to $8.9 million in 2006; the Department has been among the top ten family medicine departments nationally in total NIH grant-funding levels since 2003. Since 2003, the Division has also sponsored the development of a practice-based research network, the New York City Research Improvement and Networking Group (NYC-RING), which now includes over 25 affiliated practices and has received a growing number of grants to conduct collaborative research projects in our patients’ communities.
The Department’s Division of Community Health, and the affiliated Institute for Community Health at AECOM, have developed numerous programs and partnerships to help promote health education, peer support, community empowerment, and research pertaining to community health and advocacy. This includes HRSA-funded Hispanic Center of Excellence (HCOE) at AECOM, as well as the NIH-funded Bronx Center to Reduce and Eliminate Ethnic and Racial Health Disparities (BXCREED).
We believe health is a state of physical, social, economic, psychological, and political well-being. We believe health care is a right that is a matter of social justice. There is a social component in the origin and course of disease; therefore, to promote health, we support community action and progressive change in public policy and social structure, both at a local level and more broadly.
We are dedicated to the full application of the biopsychosocial model through understanding the ecological context of the patient's and family's social system in underserved communities. We are dedicated to the integration of the perspectives of public health and clinical medicine with lessons learned from complementary therapies in our health care and healing. We seek to work collaboratively with patients and their families, colleagues and communities to provide excellent patient-centered care, explore innovations in primary care, and support a context that fosters health by providing culturally sensitive and respectful care that empowers all those involved.
We value diversity, oppose prejudice and discrimination, and seek to advocate effectively for those who are disenfranchised and underserved by the existing health care system.
We invite you to find out more about us, partner with us, and work with us to help achieve the goals of health and social justice in the Bronx and beyond.