“Family Medicine’s Task in Population Health: Defining It and Owning It” Begins With the Community

As family physicians, researchers, and educators who have been engaged in population health at the local, state, and national level for more than 3 decades, we would like to thank Drs Hollander-Rodriguez and DeVoe for their commentary on “Family Medicine’s Task in Population Health: Defining It and Owning It”1 and offer our perspectives for those who are either beginning the journey of working with their community, or like us, working to continually enhance those relationships.

We believe that population health is owned by the population, beginning with those residing in the community, as well as public health departments, community-based organizations, businesses, schools, and faith-based organizations, to name a few. As family physicians, we have important roles within this larger community, but there are a few key points to bear in mind.

One lesson we have learned is the need to begin by learning from and listening to the community. The US Department of Health and Human Services publication, Principles of Community Engagement, on which we worked, offers practical guidance, including:

Remember and accept that collective self-determination is the responsibility and right of all people in the community. No external entity should assume it can bestow on a community, the power to act in its own self-interest.2

A second lesson is the need to partner with and build on what is already underway. When possible, reach out to the local or state public health department and review their community health assessment. Many cities and states are deeply engaged in population health activities, often with a particular focus on health equity, have robust data supporting multiple programs, and welcome partnerships with family physicians. Indeed, many health officials are family physicians! This focus on partnerships is also one of the themes of the report of the (then) Institute of Medicine, Primary Care and Public Health: Exploring Integration to Improve Population Health,3 as well as the subsequent work, The Practical Playbook: Public Health and Primary Care Together,4 both of which, and especially the latter, offer additional guidance and potential connections.

In working with these larger collaboratives, we have found that family medicine does not own population health, even among the traditional physician specialties.  Our prior work identified population health milestones of many specialties,5 including some unusual suspects. We are also inspired by colleagues such as Dr Mona Hanna-Attisha, who identified the Flint, Michigan water crisis and continues to work for its resolution while serving as pediatric residency director for the Hurley Medical Center program.

There is enormous opportunity for family physicians, individually and collectively, to improve the health of our communities. It is indeed time to seize the moment and join the movement that is already well underway, and to which we can collaboratively add our voices, data, skills, and commitment to learn how we can improve the health of all.