Fifty years of contributions of behavioral science in family medicine

Behavioral Science has made innovative and integral contributions to the evolution of family medicine over the past 50 years. This paper divides this journey into four developmental eras: Early Years, Middle Years, Recent Years, and the Future. Over this time, the family physician’s role in treating behavioral health concerns has changed from primary responsibility to new models of collaboration and team care. Likewise, behavioral scientists in family medicine have enhanced their scope of attention from the foundational focus on family dynamics and behavioral health care, to physician well-being, contextual care, and team-based communication. The educational and clinical functions of behavioral science faculty have expanded, with significant contributions to esearch and scholarly work that have defined academic family medicine, and development of leadership roles within clinical teams, academic departments and centers, and larger health systems. The new specialty of family medicine was founded upon a broad biopsychosocial agenda. “The sine qua non of family practice is the knowledge and skill which allow the family physician to confront relatively large numbers of unselected patients with unselected conditions and to carry on therapeutic relationships with patients over time.^”1 Founders of the academic discipline of family practice (now family medicine) carefully considered how to practice and teach this unique and needed specialty. What were the skills needed for patient communication, maintaining long-term relationships, and managing patients within the context of families and communities? Many physicians, behavioral scientists, educators and researchers have tried to answer these questions.² Their body of work is the 50-year academic history of behavioral science in family medicine.