SPECIAL COMMUNICATION A Short History of Primary Care Practice-based Research Networks: From Concept to Essential Research Laboratories

Sail forth—steer for the deep waters only, reckless O Soul, exploring, I with thee, and thou with me, for we are bound where mariner has not yet dared to go, and we will risk the ship, ourselves and all. —Walt Whitman This is a story about the evolution of practice-based research networks (PBRNs) in the United States. It is largely a story about family physicians, but it includes important work by clinicians in other dis-ciplines, especially pediatrics. As with all histories, the viewpoint is that of the authors, who have not been dispassionate observers. Larry Green has been a prime mover of these events from the beginning. John Hickner came on the PBRN scene at the 1983 North American Primary Care Research Group meeting in Banff, Canada, where he decided he “wanted to be just like those Ambulatory Sentinel Practice Network (ASPN) guys. ” This synopsis does not adequately capture the enthusiasm, en-ergy, professional risk, volunteerism, and devotion of the many academic and community physicians, researchers, office staffs, and patients who have worked together to improve and transform primary care by carefully observing and interpreting the phenomenon of primary care practice as it unfolds each day. We have included references that contain bits of PBRN history and lore for those who wish to know more about what the Institute of Medicine called “the most promising infrastructure develop-ment that [the committee] could find to support better science in primary care.”1 This article incor-porates information previously published in a monograph by the American Academy of Famil