Scope of Practice Among Rural Family Physicians in Patient Centered Medical Homes
A recent study conducted by researchers from the American Board of Family Medicine (ABFM) indicates rural family physicians who work in a Patient Centered Medical Home (PCMH) practice have a broader scope of practice than those not in PCMH practices.
The research team surveyed 3,121 rural family physicians who sought to continue their ABFM certification in 2014 and 2015. Of the 3,121 rural family physicians, 1,248 were in large rural areas, 1,601 in small rural areas, and 272 were in frontier areas. The findings showed physicians practicing in PCMH practices in both large rural areas and small rural areas was associated with a wider scope of clinical practice when compared to physicians in non-PCMH practices in large rural areas and small rural areas. The difference in scope of clinical services was significant in 16 of the 21 clinical services analyzed for large rural areas and in 17 of 21 clinical services analyzed for small rural areas. With frontier areas, there were no significant differences observed between physicians practicing in PCMH and non-PCMH practices except for chronic disease management and preventive services.
The findings from the study indicate the PCMH model is meeting its goals of providing patients with more accessible, comprehensive, and coordinated health care. While previous research showed a decline in family physicians providing pediatric, mental health, and women’s health care, this study found that rural PCMH practices were providing these services at high levels.
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Correspondence and inquiries should be addressed to: Lars E. Peterson, MD, PhD, American Board of Family Medicine