title: Challenges to academic family medicine in the current health care environment.
abstract: BACKGROUND
  Changes in health care delivery and funding have placed strains on academic medical centers' ability to meet their multiple missions. To gain insight into how this new academic landscape is affecting academic primary care, this study examined the current status and perceived challenges at nine departments of family medicine at allopathic and osteopathic medical schools.
  
  
  METHODS
  Site visits were made to nine academic departments of family medicine where key informant interviews were conducted with several individuals in key leadership positions. Sites were chosen to maximize diversity among departments along a variety of factors, such as location, size, mission, and type of school (private versus public). Interviews were transcribed and analyzed by a three-person multidisciplinary team for key themes.
  
  
  RESULTS
  Analysis of interviews revealed five major challenges for academic departments of family medicine: 1) adjusting to new clinical demands in the academic health center, 2) organizing and administering new initiatives in community-based education, 3) recruiting and retaining faculty, 4) developing and maintaining research capacity, and 5) serving multiple missions (education, clinical care, and academic pursuits) in times of financial restraint.
  
  
  CONCLUSIONS
  Significant challenges face academic departments of family medicine. The success or failure of departments of family medicine to meet these challenges could serve as a bellwether for how primary care fits into the future overall scheme of academic health centers.
authors.affiliation: Department of Family Medicine, Medical University of South Carolina, USA. huestowj@musc.edu
authors.forename: W J
authors.initials: WJ
authors.lastname: Hueston
authors.forename: A G
authors.initials: AG
authors.lastname: Mainous
authors.forename: C
authors.initials: C
authors.lastname: Bazell
authors.forename: M K
authors.initials: MK
authors.lastname: Connor
mesh_terms: D003220:Conflict, Psychological; D003479:Curriculum; D017598:Efficiency, Organizational; D005194:Family Practice / Q000193:education* / Q000458:organization & administration; D006302:Health Services Research; D009936:Organizational Innovation; D009937:Organizational Objectives; D012577:Schools, Medical / Q000458:organization & administration / Q000639:trends*