The National Strategic Plan for Family Medicine Research emerged from an extensive and inclusive process, beginning with a listening tour to understand past efforts to bolster research within the discipline. This listening tour revealed key themes that echoed findings from initiatives in the early 2000s led by family medicine leaders. Building on this foundation, the ADFM and NAPCRG secured funding from the American Board of Family Medicine (ABFM) Foundation to support strategic planning efforts, including hosting a research summit. With this funding, Clarus Consulting Group was engaged to guide the planning process, incorporating broad input from stakeholders across the discipline.

Clarus facilitated interviews, focus groups, and visioning surveys that included students, residents, researchers, program directors, research directors, department chairs, and patient communities. The data collected from these efforts were synthesized into actionable themes, which formed the basis of the strategic plan. A planning committee was convened to organize a research summit, held in conjunction with the 2023 NAPCRG Annual Meeting. This summit brought together over 140 leaders, innovators, and visionaries in family medicine. Attendees engaged in dynamic, participatory discussions using innovative approaches to prioritize actionable steps for each strategic priority. Importantly, the group envisioned family medicine research to be: “whole-person, family, and community centered and improves health by enhancing health promotion, improving care for chronic diseases and advancing healthcare delivery, while including cross-cutting themes of health equity, technology, and team science.”

In parallel, the Family Medicine Leadership Consortium (FMLC)—comprising executive committees from the eight major family medicine organizations—reviewed the plan and contributed to its development. These organizations volunteered to lead specific areas within the strategic plan, ensuring broad representation and accountability. Additionally, a special issue was commissioned and published in the Journal of the American Board of Family Medicine to highlight the plan’s goals and document the progress and opportunities in family medicine research.

The culmination of these efforts—the Summit, the Strategic plan, and the Special issue—represents a unified and collaborative vision for advancing family medicine research. By leveraging the collective expertise of the discipline and fostering partnerships across various sectors, the plan provides a roadmap for transformative research that will improve health outcomes for patients, populations, and communities.

The National Strategic Plan for Family Medicine Research was developed with a specific focus on family medicine because of its unique role, scope, and potential within the broader primary care ecosystem. While we deeply value the interdisciplinary collaboration that defines primary care—and recognize that many of the plan’s initiatives will benefit all primary care disciplines—the focus on family medicine is intentional and strategic for several reasons.

1. Addressing Family Medicine’s Unique Scope and Challenges:
   Family medicine is the only primary care specialty that provides comprehensive care for individuals and families across the lifespan, encompassing all genders, conditions, and care settings. This breadth requires a distinct research agenda that addresses the unique challenges and opportunities faced by family physicians. Despite the critical role family medicine plays in healthcare delivery, it has historically been underfunded and underrepresented in research compared to other medical specialties. This plan seeks to close that gap, recognizing that strengthening family medicine research will also enhance primary care as a whole.
   
   
2. Leveraging Family Medicine’s Leadership in Whole-Person, Community-Centered Care:
   Family medicine is uniquely positioned to lead research that addresses whole-person care, the social determinants of health, and the integration of care across systems. These are foundational elements of primary care, and advancing research in these areas through a family medicine lens will generate evidence that benefits all primary care disciplines. By focusing on family medicine’s leadership in these domains, the plan seeks to create a ripple effect across the primary care spectrum.
   
   
3. Building on Family Medicine’s Research Capacity:
   While primary care disciplines share many research priorities, family medicine faces distinct barriers and opportunities that require tailored solutions. For instance, family medicine departments often lack the dedicated research infrastructure seen in other specialties. This plan provides a roadmap for addressing these gaps through mentorship, advocacy, and infrastructure development, laying a foundation that can be adapted or scaled to benefit other primary care disciplines.
   
   
4. Serving as a Model for Broader Primary Care Research Initiatives:
   Although this plan is family medicine-focused, it is not exclusive. We view this initiative as a potential model for broader primary care research efforts. By addressing specific challenges within family medicine, we hope to establish scalable frameworks, partnerships, and funding pathways that can be leveraged across the primary care landscape. Collaboration with NAPCRG and other primary care stakeholders will be essential in ensuring this plan’s impact extends beyond family medicine.
   
   
5. Promoting Collaboration Across Primary Care Disciplines:
   Finally, while the plan focuses on family medicine, it is designed with collaboration in mind. Many of the priorities—such as building pathways for mentorship, securing funding, and developing infrastructure—align closely with the goals of other primary care disciplines. We see this plan as an opportunity to strengthen the collective research capacity of primary care, with family medicine serving as a critical anchor within that effort.

What is the difference between Family Medicine and Primary Care?

The American Academy of Family Physicians recognizes the term "primary care" and acknowledges that family physicians provide services commonly associated with primary care. However, the terms "primary care" and "family medicine" are not interchangeable. "Primary care" is a broad term that encompasses a range of services and specialties, while "family medicine" is a distinct medical specialty with unique training, scope, and philosophy. Similarly, primary care departments do not replace the form or function of family medicine departments.

Primary Care
Primary care is an integrated and accessible healthcare approach delivered by physicians and their teams, serving as the entry point and central hub for healthcare services. Primary care focuses on:

• Meeting most personal health needs through first-contact, comprehensive, and continuous care.

• Managing undiagnosed or diverse health concerns in a variety of settings, including health promotion, disease prevention, and acute and chronic illness management.

• Providing person- and family-centered, team-based care while collaborating with specialists as needed to ensure coordinated and high-value services.
  Primary care is provided by physicians from several specialties, including family medicine, internal medicine, and pediatrics, who may be considered Primary Care Providers (PCPs).

Family Medicine
Family medicine is a medical specialty uniquely qualified to provide comprehensive health care for individuals and families across all ages, genders, diseases, and parts of the body. Family physicians are trained to offer a breadth of services and build enduring, trusting relationships with patients over time. Key characteristics of family medicine include:

• Care Across the Lifespan: Family physicians provide care for people of all ages, from newborns to seniors, addressing a wide variety of medical conditions and health needs.

• Whole-Person Care: Family physicians consider the biological, psychological, and social aspects of health and their impact on the patient and their family.

• Community and Social Determinants of Health: Family physicians are trained to understand and address community-level factors and social determinants of health, recognizing how these influence individual and population health.

• Care Coordination: Family physicians navigate the healthcare system with their patients, coordinating specialist and hospital care, ensuring appropriate follow-up, and advocating for their patients' needs.

• Data and Technology Integration: Family physicians use data and technology to enhance care coordination and improve patient outcomes.

While primary care describes the broad approach of providing accessible and integrated health services, family medicine represents a specific discipline within primary care that embodies a unique philosophy of care, a commitment to comprehensive training, and a deep connection to the community and patient-centered care.

The decision to create a Research Strategic Plan focused on the United States stemmed from the recognition that family medicine research in the U.S. lags behind both other U.S. medical specialties and family medicine research globally. Despite the pivotal role family medicine plays in delivering primary care, the discipline has historically struggled to secure adequate research funding and build the infrastructure needed to generate high-impact, practice-changing evidence.

In comparison to other U.S. departments, family medicine receives disproportionately low levels of funding and support. For example, the total NIH funding for the entire discipline of family medicine in 2021 was only twice the average funding allocated to a single department of internal medicine². This gap underscores the urgent need for a focused and strategic approach to bolster the research capacity and academic rigor within U.S. family medicine.

Internationally, family medicine research in countries like Canada and those in Europe has made significant strides, often serving as a model for robust primary care research systems. Programs such as Canada’s TUTOR-PHC initiative³ and the Netherlands' integrated PhD training programs⁴ have established strong infrastructures to support primary care research, while the U.S. has lagged behind. A U.S.-focused research strategic plan is not only critical for advancing family medicine domestically but also positions the U.S. to collaborate with and learn from these international leaders.

Additionally, the complexity of the U.S. healthcare system, coupled with a significant shortage of primary care physicians, necessitates a tailored strategy. Addressing these unique challenges requires research that is context-specific and capable of informing policy, improving patient outcomes, and reducing disparities across diverse communities.

Finally, by establishing a research strategic plan in the U.S., we can create a blueprint that may serve as a foundation for similar efforts in other countries. A strong and successful U.S. strategic plan has the potential to inspire and guide global efforts to enhance family medicine research, fostering international collaboration and progress.

In summary, the U.S. Research Strategic Plan for Family Medicine is essential to close gaps in funding, infrastructure, and research output, address the unique challenges of the U.S. healthcare system, and align the discipline with global leaders in primary care research.

International partners play a vital role in advancing family medicine research by providing valuable insights, resources, and opportunities for collaboration. By learning from countries with successful research programs, we can adopt best practices and innovative strategies to strengthen our discipline in the U.S. and globally. Many countries, such as Canada, the Netherlands, and Australia, have established robust primary care research infrastructures that can serve as models for building research capacity, securing funding, and fostering collaboration.

Mentorship and Pathways:
International partners can contribute to developing mentorship and research pathways by sharing models that have proven effective in their contexts. For instance, Canada’s TUTOR-PHC program, which integrates mentorship and interdisciplinary training for primary care researchers, can inspire similar initiatives in the U.S. Additionally, international collaborations can provide training opportunities for U.S.-based family medicine researchers, enhancing their exposure to global perspectives and methods.

Funding and Advocacy:
Global partnerships can help advocate for increased funding and support by demonstrating the value of investing in primary care research. Collaborating on joint funding applications or showcasing successful international examples of government-supported research can strengthen advocacy efforts. Furthermore, partners can help explore alternative funding sources, such as international grants or philanthropic initiatives, to support family medicine research globally.

Infrastructure Development:
In the area of infrastructure, international partners can offer expertise in creating and sustaining primary care research networks. Many countries have established national or regional research networks that integrate data systems, coordinate multi-site studies, and drive impactful research. These examples can inform the development of similar networks in the U.S. Additionally, partnering on cross-national studies can allow for shared infrastructure, resources, and expertise, enabling robust and diverse research findings.

Collaborative Research Projects:
International partnerships also open doors to collaborative projects that address global health challenges, such as health equity, chronic disease management, and innovative care delivery models. These collaborations can provide comparative insights, promote knowledge exchange, and accelerate the generation of evidence that benefits diverse populations.

By working together across borders, we can build a stronger, more interconnected research ecosystem that advances the goals outlined in the strategic plan and enhances the global impact of family medicine research.