What Is Family Medicine Research?

Family medicine is the medical specialty that provides continuing, comprehensive care to people of all ages, usually as the first point of contact with the health system. Primary care is the broader term for that first-contact, ongoing, whole-person care, and it is delivered by family physicians and also by general internists, pediatricians, nurse practitioners, physician associates and others, depending on the country and the health system. Primary care and family medicine research is the body of study that asks how this kind of care works, who receives it, what it achieves and how it can be improved. This guide explains the specialty and the research field, how the research is organized (including practice-based research networks), the methods it uses, who trains in it, which societies, journals and funders are involved, and why it matters to research administrators.

Family Medicine and Primary Care: Definitions

The two terms overlap but are not identical, and the difference matters when you search the literature or read a funding announcement.

Family medicine is a physician specialty. In the United States a family physician completes residency training in family medicine and can care for infants, adults and older people, for acute illness, chronic disease, prevention and many common procedures. In the United Kingdom and several other countries the closely related discipline is usually called general practice, and the physician a general practitioner (GP). The vocabulary differs by country; the underlying idea of a generalist physician who knows a patient over time is shared.
Primary care is a function and a setting rather than a single profession. It describes the first level of contact, the continuing relationship with a patient or family, coordination of care across other services, and attention to the whole person instead of one organ system or disease. Several professions deliver it.
Internal medicine is a separate specialty focused on adult medicine. General internists practise primary care in many settings, while subspecialists in internal medicine (cardiology, gastroenterology and so on) usually work at the referral level. Family medicine and general internal medicine therefore share a great deal of research territory, particularly chronic disease management in adults, but family medicine also covers children, pregnancy-related care and the family context.

Because primary care is where most people first meet the health system and where most conditions are first recognized, its research questions look different from those of a specialty clinic. The patients have undifferentiated symptoms, several problems at once and a history with the clinician. The evidence gathered in a referral hospital does not always transfer cleanly to that setting, which is one of the main reasons the field exists as a research discipline in its own right.

What Primary Care Research Covers

Primary care and family medicine research is defined more by setting and perspective than by one disease. Typical areas include:

Prevention and screening: how effective screening, immunization and counselling are when delivered in routine practice, and how to reach people who do not attend.
Chronic disease management: care of long-term conditions, often several at once (multimorbidity), including medication use and self-management support.
Diagnosis in undifferentiated illness: how clinicians reach a diagnosis from early, vague symptoms, and how accurate common tests and decision rules are when disease prevalence is low. Diagnostic accuracy work of this kind relies on tools such as QUADAS-2.
Mental health in primary care: detection and treatment of common conditions such as depression and anxiety in general practice, alongside links to psychiatry.
Care across the life course: child health (see pediatrics), pregnancy and postpartum care (see obstetrics and gynecology), and care of older adults (see geriatrics).
Health care delivery: access, continuity, team-based care, payment models and the use of electronic records and other digital tools, which overlaps with health services research and health informatics.
Population and community health: social determinants of health and the relationship between clinical practice and local communities, which connects to public health and epidemiology.
Medical education: how generalist physicians are selected, trained and retained, a strand of the field that societies for family medicine teachers have long supported.

Research Methods Used in Primary Care

The field draws on nearly every method in clinical and health research, chosen to fit the question and the setting.

Randomized trials, including pragmatic trials that test an intervention under ordinary practice conditions instead of tightly controlled ones, and cluster randomized trials in which whole practices, not individual patients, are randomized. These designs suit questions about how care is organized, since a clinic cannot easily deliver two different workflows to patients sitting in the same waiting room.
Observational studies, such as cohort and case-control designs using practice records or registries, and longitudinal studies that follow patients over years, which suits the continuing relationships typical of primary care.
Qualitative research, including interviews, focus groups and observation, used to understand how patients and clinicians experience care, why an intervention was or was not adopted, and what a consultation looks like in practice.
Mixed methods, combining numbers with narrative, common in evaluations of changes in how a practice works.
Systematic reviews and meta-analyses, which synthesize trial and observational evidence to answer questions clinicians face daily.
Implementation and quality-improvement research, concerned with how proven interventions are taken up in real practices and how to sustain them; see the stages of translational research for where this sits in the pipeline from discovery to population benefit.
Comparative effectiveness research, which compares existing options in routine care; see the dictionary entry on comparative effectiveness research.

Practice-Based Research Networks

A practice-based research network (PBRN) is a group of clinical practices, often joined by academic researchers, that work together to study questions arising from everyday care. The practices are not just sites that supply patients: clinicians and practice staff help to choose the questions, shape the design and interpret the results. PBRNs exist because much of what happens in primary care is hard to study in a hospital or a single academic clinic. By pooling many ordinary practices, a network can recruit patients who resemble the people actually seen in the community and can test interventions in the settings where they will be used.

In the United States, PBRNs have been a recognized feature of primary care research for decades. Federal health research agencies, notably AHRQ, have been associated with supporting such networks. The specific history of individual networks, their sizes and their funding differs widely, so this guide does not generalize about them; consult each network’s own pages for details.

Research administrators who support PBRN studies encounter a distinct set of tasks. Many sites are small independent practices without their own institutional review board, which raises questions about reliance agreements and single IRB review; each practice may need a subaward or site agreement; and data-sharing arrangements have to address practice-level confidentiality as well as patient privacy. Engaging clinicians and patients as partners also shapes budgets and timelines; see the entry on patient partners and the guide on patient engagement in clinical trials.

Professional Societies

American Academy of Family Physicians (AAFP): the national professional organization of family physicians in the United States. It publishes clinical and practice resources for its members.
Society of Teachers of Family Medicine (STFM): describes itself as a national community dedicated to advancing academic family medicine education. Its own materials say it has worked for nearly 60 years and serves roughly 6,400 members. It publishes the journal Family Medicine and a secondary publication, PRiMER, and supports the CAFM Educational Research Alliance (CERA), which it describes as a framework to support medical education research.
North American Primary Care Research Group (NAPCRG): describes itself as a leading global advocate for primary care research, committed to nurturing and supporting learners and interdisciplinary professionals at all career stages. Its stated mission is to support the creation of new knowledge and evidence that transforms health and health care worldwide. It holds an annual meeting with presentations, pre-conference workshops, special interest groups, and awards and stipends for trainees.

Outside North America, national colleges of general practitioners and the international family medicine organizations play parallel roles. This guide describes only the three above, which are the bodies named in most US primary care research contexts.

Funders of Primary Care Research

Primary care research is funded from several directions, and which one fits depends on the question.

Patient-Centered Outcomes Research Institute (PCORI): an organization that, in its own words, funds patient-centered comparative clinical effectiveness research. It was authorized by Congress in 2010, says it has funded more than 2,600 research and related projects, and emphasizes involving patients throughout the research process. It also supports PCORnet, described as a national resource for enhancing research capacity. Many of PCORI’s priorities, such as comparing treatment options in routine care and engaging patients and clinicians as partners, align with primary care questions. Our guide on writing a PCORI research proposal covers applicant considerations.
Agency for Healthcare Research and Quality (AHRQ): the US federal agency whose mission centres on health services research and health care quality and safety. It has been a long-standing source of support for primary care research infrastructure, including practice-based research networks. Check current announcements directly, as the agency’s programs and budget change over time.
National Institutes of Health (NIH): several institutes support research that is conducted in or relevant to primary care, such as chronic disease, mental health, aging and child health. Primary care studies also use NIH-supported clinical and translational research infrastructure.
Foundations, health systems and professional bodies: smaller grants, fellowships and practice-improvement awards are often available through foundations and the societies above.

Programs, award sizes and eligibility change from year to year, so this guide does not quote specific amounts or deadlines. Always read the current funding announcement.

Journals

Annals of Family Medicine: a peer-reviewed journal devoted to primary care and family medicine research; STFM’s own materials list it among the publications it is associated with.
Family Medicine: the official journal of STFM, with a strong emphasis on education.
PRiMER: a secondary publication from STFM.
General medical journals and general internal medicine journals also publish primary care trials and reviews, so a literature search should not stop at specialty titles. See the comparison of CINAHL and PubMed when planning a literature search.

Training and Career Paths

In the United States, a physician becomes a family physician by completing medical school followed by a residency in family medicine, and then may pursue certification and, for those who want to specialize further, fellowships in areas such as geriatric medicine, sports medicine or research. A research-oriented career usually adds a research fellowship or a graduate degree in epidemiology, health services research, public health or clinical investigation. Nurse practitioners and physician associates follow their own pathways, and nursing science contributes heavily to primary care research; see nursing science. Training structures in other countries differ, and readers outside the United States should consult their own national college or regulator.

Primary care research careers have some distinctive features. Researchers are often also practising clinicians, which keeps questions grounded but limits protected time. Early-career researchers frequently depend on mentored career development awards, fellowships and network membership to build independence.

How Primary Care Research Relates to Neighbouring Fields

Health services research studies access, quality, cost and organization of care across the system; primary care research is one of its main subjects but also asks clinical questions that health services research does not.
Public health works at the population level; primary care works at the person and family level, and the two meet in prevention, screening and community programs.
Pediatrics and geriatrics are specialties defined by age group, while family medicine spans the whole life course and often shares research questions with both.
Emergency medicine and primary care share an interest in undifferentiated presentations and in how patients move between settings.

Why It Matters for Research Administration

Primary care studies are administratively different from a typical single-site laboratory or hospital project. They often involve many small, geographically dispersed sites; they depend on clinician time that must be budgeted and reimbursed fairly; they use routinely collected health data that carry privacy and data-use obligations; and they commonly involve patients and community members as partners. Research offices that learn these patterns early can shorten start-up, particularly the IRB reliance, subaward and data-sharing steps. Pragmatic and cluster-randomized designs also raise consent questions that an IRB must decide case by case. For the broader context of clinical studies see the dictionary entries on clinical research and translational research.

Frequently Asked Questions

What is the difference between family medicine and primary care?

Family medicine is a medical specialty practised by family physicians. Primary care is the wider concept of first-contact, continuing, coordinated care, which family physicians deliver together with general internists, pediatricians, nurse practitioners and other clinicians.

Is general practice the same as family medicine?

The terms are used for closely related disciplines in different countries. “General practice” is common in the United Kingdom and many Commonwealth countries; “family medicine” is the usual term in the United States and Canada. Training, scope and regulation differ by country.

What is a practice-based research network?

It is a group of clinical practices that collaborate, usually with academic partners, to answer research questions arising from everyday care, with clinicians helping to shape the work.

How is primary care research different from research in a hospital?

Patients present earlier, with less clear symptoms and often several conditions at once, and care is delivered over time in a community setting. Findings from referral hospitals may not apply directly, so primary care studies are designed for these conditions.

Who funds primary care research?

Funders include PCORI, AHRQ and NIH in the United States, together with foundations, health systems and professional societies. Priorities and programs change, so check current announcements.

Which societies support family medicine research?

In North America, AAFP, STFM and NAPCRG are the main bodies, each with a different emphasis: professional practice, education and research respectively.

Does this guide give medical advice?

No. It describes a discipline and a research field. For personal health decisions, consult a qualified clinician.

What Is Primary Care and Family Medicine Research?