The Future Role of the Family Physician in the United States: A Rigorous Exercise in Definition

Abstract

As the US health care delivery system undergoes rapid transformation, there is an urgent need to define a comprehensive, evidence-based role for the family physician. A Role Definition Group made up of members of seven family medicine organizations developed a statement defining the family physician's role in meeting the needs of individuals, the health care system, and the country. The Role Definition Group surveyed more than 50 years of foundational manuscripts including published works from the Future of Family Medicine project and Keystone III conference, external reviews, and a recent Accreditation Council on Graduate Medical Education Family Medicine Milestones definition. They developed candidate definitions and a "foil" definition of what family medicine could become without change. The following definition was selected: "Family physicians are personal doctors for people of all ages and health conditions. They are a reliable first contact for health concerns and directly address most health care needs. Through enduring partnerships, family physicians help patients prevent, understand, and manage illness, navigate the health system and set health goals. Family physicians and their staff adapt their care to the unique needs of their patients and communities. They use data to monitor and manage their patient population, and use best science to prioritize services most likely to benefit health. They are ideal leaders of health care systems and partners for public health." This definition will guide the second Future of Family Medicine project and provide direction as family physicians, academicians, clinical networks, and policy-makers negotiate roles in the evolving health system. INTRODUCTIONA t the turn of the century, family medicine leaders organized the Keystone III Conference to "examine the soul of the discipline of family medicine, and to take stock of the present and grapple with the future of family practice." 1 This conference inspired the major family medicine organizations to organize the Future of Family Medicine Project (FFM) charged to " [d]evelop a strategy to transform and renew the specialty of family practice to meet the needs of people and society in a changing environment." Many successes were born out of FFM, but the decade that followed saw erosion of primary care training, a decline in student and resident interest, and a widening of the physician income gap. Currently, while family medicine and primary care are fighting pressures from insurers and purchasers, they are enjoying a renaissance thanks to considerable forces for health reform, including the Affordable Care Act. The major family medicine organizations have launched the FFM 2.0 Project to offer leadership in how family medicine responds to these opportunities.Despite at least 1 attempt to characterize the family physician's role a decade ago, 3 family medicine's lack of a role definition hampered its ability to prioritize and strategize its advocacy:The role of family practice in US culture is now less clear than...

Family Medicine for America’s Health—4 Years Later, Heading Into the Future

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Health Is Primary: Family Medicine for America's Health

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The Influence of Family Physicians Within the South African District Health System: A Cross-Sectional Study

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