In 1969 Family Medicine was organized as a distinct medical specialty in the United States. 1970 saw the Waco Family Medicine Residency begin its teaching program as the first accredited FM residency in Texas and possibly the oldest west of the Mississippi. The fruit of the visionary leadership of the McLennan County Medical Society, the program’s inception brought together city and county leaders as well as the local Baptist and Catholic hospitals with Waco physicians in a united effort to provide care for the area’s poor and to provide an ongoing supply of physicians for a city and county that were increasingly medically underserved. Initially conceived as a 4-4-4 program, the residency has grown to 12-12-12 and is governed by the McLennan County Medical Education and Research Foundation. Through its first decade the residency and clinic thrived, operating in donated space in the basement of Providence Hospital.
By 1983, enthusiastic support from the medical and civic communities permitted the program to construct a bigger, freestanding residency facility and community clinic. The 1980s brought the program increasing success and diversity with the pioneering of a family medicine Faculty Development Center that became renowned for the quality of family medicine faculty it produced. Eventually, Dr. Bill Mygdal who directed the center, would go on to become the president of the Society of Teachers of Family Medicine, the premier organization promoting the education of residents. In 1989 the Institute of Medicine in a large, federally funded study, cited the Waco Family Medicine Residency Program as the outstanding example in the United States of the optimal way to fund and operate a community-based residency program.
The 1990s saw the program affiliate with UT Southwestern, expand facilities and increase the size of its resident class to the current size of 36 residents. Additional faculty members were added and pioneering use of internet technology in patient care was begun. The program became one of the first academic customers of Epic Corporation and was involved in testing and implementation of their electronic medical record system (now called EpicCare) before it was released. The program continues in its affiliation with Epic and in 2009 was awarded the prestigious Healthcare Information and Management Systems Society (HIMSS) Davies Award for improving patient outcomes through the use of an electronic medical record.
During this same decade the residency’s clinic population expanded and the program became more and more indispensible in providing primary care to the poor of the Waco area. At the same time as the need for services was outstripping the capacity of the program, funding mechanisms for both medical education and patient care became increasingly inadequate. 1999 saw a restructuring of the program resulting in a Federally Qualified Health Center PLUS a family medicine residency training program, designated as operating in a medically underserved area. This designation helped the program financially, gave us federal medical liability protection and qualified some of our employees for educational loan forgiveness.
The first decade of the new millennium has seen another round of expansion of the residency and clinic. Additional medical, and, for the first time, dental facilities were developed to be staffed with practicing clinicians including many of our own graduates. At the same time, we diversified our medical services to include OB/GYN and psychiatric care allowing us to provide enhanced resident training in these contexts within our clinic system for the first time. The program also began operating the Brazos AHEC (Area Health Education Center), with their mission overlapping ours, to “strive to improve the supply, distribution, diversity and quality of the health care workforce, ultimately increasing access to health care in medically underserved areas.” This decade also saw the election of Dr. Roland Goertz, the Center’s CEO, to the presidency of the AAFP, the American Academy of Family Physicians, the premier national medical society promoting family medicine. Achievements like this highlight our residency program and its continuing commitment to excellence in post-graduate medical education.
As the program moves into this second decade we continue to grow. We recently enhanced our mental health care services and training with the inauguration of an integrated human behavior and mental health clinic led by our faculty clinical psychologist. Concurrently we are developing research and patient care collaborative work with Baylor University and a completed a simulation curriculum and center with McLennan Community College. Finally, within the next five years we anticipate completing the transition to a Patient Centered Medical Home designation coupled with the construction of an entirely new, state-of-the-art residency clinic. Pioneering initiatives like these highlight the continuing commitment of the Waco Family Medicine Residency Program to excellence in postgraduate medical education.