The Evolving Family Medicine Team
Understanding how family medicine care evolves is imperative given the importance of team-based care and evidence suggesting that a team-based structure is essential for the primary care workforce to meet the chronic and preventive care needs of the population.
Previous research has shown that a majority of family physicians report working with nurse practitioners (NPs), while fewer work with non-billing team members such as social workers. However, as the number of nonphysician providers grows, allowing expansion of alternative payment models that support the addition of non-billing providers, team-based care in family medicine is likely to change.
A recent study using five years of practice demographic questionnaires from the American Board of Family Medicine found that approximately half of the physicians work with an NP, a registered nurse (RN), and steadily increasing over more recent years, a licensed practical nurse (LPN). In 2018, almost 25% of family physicians also worked with clinical pharmacists, behaviorists, and social workers – with an increase in numbers over the preceding four years. The number of family physicians working with NPs and physician assistants (PA) increased over the time period, but not continually from year-to-year.
Researchers noted a trend of year-to-year increases in the percentage of family physicians working with certain types of providers, such as RNs, LPNs and social workers; however, this was not the case with NPs, PAs or physical therapists/occupational therapists. In 2017, a change in wording to include “collaboratively” was added to the question asking which types of health professionals work (collaboratively) with you at your practice site. This change may have affected the decrease in percentages for those working with PAs and NPs.
Further work is needed to determine the optimal composition of team-based care in family medicine, especially as practices continue to transform and new payment models are introduced.
The full article, The Evolving Family Medicine Team, can be found by clicking here.