What Services Do Family Physicians Provide in a Time of Primary Care Transition?

Bazemore, Andrew; Petterson, Stephen; Johnson, Nicole R; Xierali, Imam M.; Phillips, Robert L.; Rinaldo, Jason; Puffer, James C.; Green, Larry A.

doi:10.3122/jabfm.2011.06.110171

Cited by 21 publications

(16 citation statements)

References 3 publications

(1 reference statement)

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“…Not surprisingly, numerous methods have been used to define and measure comprehensiveness that have focused on settings of care, 7 types of care provided [12][13][14] or a mix of settings, types of care and procedures. 6 Comprehensiveness can also be measured from a number of perspectives, including provider report, patient report and administrative claims.…”

Section: Open Cmaj Open 5(4) E861mentioning

confidence: 99%

Identification of physicians providing comprehensive primary care in Ontario: a retrospective analysis using linked administrative data

Schultz

Glazier

2017

CMAJ Open

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Background: Given the changing landscape of primary care, there may be fewer primary care physicians available to provide a broad range of services to patients of all age groups and health conditions. We sought to identify physicians with comprehensive primary care practices in Ontario using administrative data, investigating how many and what proportion of primary care physicians provided comprehensive primary care and how this changed over time. Methods:We identified the pool of active primary care physicians in linked population-based databases for Ontario from 1992/93 to 2014/15. After excluding those who saw patients fewer than 44 days per year, we identified physicians as providing comprehensive care if more than half of their services were for core primary care and if these services fell into at least 7 of 22 activity areas. Physicians with 50% or less of their services for core primary care but with more than 50% in a single location or type of service were identified as being in focused practice. Results:In 2014/15, there were 12 891 physicians in the primary care pool: 1254 (9.7%) worked fewer than 44 days per year, 1619 (12.6%) were in focused practice, and 1009 (7.8%) could not be classified. The proportion in comprehensive practice ranged from 67.5% to 74.9% between 1992/93 and 2014/15, with a peak in 2002/03 and relative stability from 2009/10 to 2014/15. Over this period, there was an increase of 8.8% in population per comprehensive primary care physician.Interpretation: We found that just over two-thirds of primary care physicians provided comprehensive care in 2014/15, which indicates that traditional estimates of the primary care physician workforce may be too high. Although implementation will vary by setting and available data, this approach is likely applicable elsewhere. AbstractResearch OPEN CMAJ OPEN, 5(4) E857

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Section: Open Cmaj Open 5(4) E861mentioning

confidence: 99%

Identification of physicians providing comprehensive primary care in Ontario: a retrospective analysis using linked administrative data

Schultz

Glazier

2017

CMAJ Open

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“…Over the past decade, studies have highlighted key areas within family medicine's traditional scope with decreasing involvement by family physicians. 54 For example, the percentage of prenatal visits that were provided by family physicians decreased by 50% from 1995 to 2004, a decline that continued through 2010. 55,56 Family physicians' provision of care to children has similarly declined: One study reported a 33% decrease in the percentage of children's office visits provided by family physicians and general practitioners between 1992 and 2002.…”

Section: -53mentioning

confidence: 99%

Back to the Future: Reflections on the History of the Future of Family Medicine

Doohan

Endres

Koehn

et al. 2014

The Journal of the American Board of Family Medicine

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These are historic times for family medicine. The profession is moving beyond the visionary blueprint of the Future of Family Medicine (FFM) report while working to harness the momentum created by the FFM movement. Preparing for, and leading through, the next transformative wave of change (FFM version 2.0) will require the engagement of multigenerational and multidisciplinary visionaries who bring wisdom from diverse experiences. Active group reflection on the past will potentiate the collective work being done to best chart the future. Historical competency is critically important for family medicine's future. This article describes the historical context of the development and launch of the FFM report, emphasizing the professional activism that preceded and followed it. This article is intended to spark intergenerational dialog by providing a multigenerational reflection on the history of FFM and the evolution that has occurred in family medicine over the past decade. Such intergenerational conversations enable our elders to share wisdom with our youth, while allowing our discipline to visualize history through the eyes of future generations. (J Am Board Fam Med 2014;27:839 -845.) Keywords: Health Policy, Medical Education, Primary Health CareThere is an urgent need for a strong and sustainable US health care system. Family medicine is uniquely positioned to lead efforts to help our nation achieve the triple aim of better health care, improved population health, and lower health care costs. [1][2][3][4][5] Reflections on the history of family medicine are central to our dialog about the future, including a critical review of key historical documents, such as the Future of Family Medicine (FFM 1.0) report. [6][7][8][9] Reviewing the history surrounding the creation of the FFM 1.0 report will help our profession prepare for the next wave of transformative recommendations (FFM 2.0).10 This article presents a multigenerational perspective on the historical context of the development and the launch of the FFM 1.0 report, emphasizing the professional activism that preceded and followed it. It is intended to spark continued intergenerational dialog on the evolution that has occurred in family medicine over the past decade as well as to provide historical context for critically interpreting and building an action plan for FFM 2.0 recommendations. Effective change will require the engagement of multigenerational and multidisciplinary visionaries who bring wisdom from diverse experiences. Historical competency is imperative; active group reflection on the past will potentiate the collective work being done to best chart the future.Historical Context, Development, and Launch of the FFM 1.0 Report Family medicine derived from general practice. Before the 20th century, the standard medical practice This article was externally peer reviewed.

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“…Future steps in tool development and administration include the use of family medicine graduate data from a standardized survey tool that is now being developed as a joint effort between the American Board of Family Medicine (ABFM) and AFMRD. In addition, refinement of metrics to reflect the current ACGME Accreditation Data [14][15][16][17] Given the importance of the PCMH model to the specialty's future, the task force chose to include whether a program's graduates were practicing in a PCMH…”

Section: Bottom Linementioning

confidence: 99%

The Residency Performance Index: An Effort at Residency Quality Assessment and Improvement in Family Medicine

Hoekzema¹,

Maxwell²,

Gravel³

et al. 2014

Journal of Graduate Medical Education

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Background Residency programs are increasingly being asked to defend their quality, and that of the residents they produce. Yet “residency quality” is a construct that has not been well defined, with no accepted standards other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors developed a strategic plan that included the goal of raising the quality of family medicine training. Objective We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first year of use by family medicine residency programs. We describe the use of the tool as a “dashboard” to facilitate program self-improvement. Intervention Using program metrics specific to family medicine training, and benchmark criteria for these metrics, the RPI was launched in 2012 to help programs identify strengths and areas for improvement in their educational activities and resident clinical experiences that could be tracked and reviewed as part of the annual program evaluation. Results Approximately 100 program directors began using the tool and 70 finished the process, and were provided aggregate data. Initial review of this experience revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a program improvement mechanism. Conclusions The RPI is a new quality improvement tool for family medicine residency programs. Although some initial challenges need to be addressed, it has the promise to aid family medicine residency in its internal improvement efforts.

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What Services Do Family Physicians Provide in a Time of Primary Care Transition?

Cited by 21 publications

References 3 publications

Identification of physicians providing comprehensive primary care in Ontario: a retrospective analysis using linked administrative data

Identification of physicians providing comprehensive primary care in Ontario: a retrospective analysis using linked administrative data

Back to the Future: Reflections on the History of the Future of Family Medicine

The Residency Performance Index: An Effort at Residency Quality Assessment and Improvement in Family Medicine

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