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    Newsletter Winter 2017

    Tuesday, December 12, 2017  The ABFM fully supports the use of certification as a means to eliminate the need for family physicians to meet burdensome privileging and credentialing requirements. However, no family physician who is not certified by the ABFM should be denied privileges or credentials if they can otherwise demonstrate their ability to provide high-quality care.

    The Winter 2017 edition of The Phoenix is now available.


    Association of Family Medicine Residency Directors and the American Board of Family Medicine Develop National Family Medicine Graduate Survey

    Thursday, November 9, 2017  Research has continually shown a decade-long decline in the scope of practice of family physicians, despite residency training designed to encompass all areas of primary care, obstetrics, impatient and ambulatory care. These findings raise questions about whether there is a lack of training, a lack of practice, or employer restrictions that limit opportunities for family physicians.

    The Accreditation Council for Graduate Medical Education (ACGME) requires family medicine residency programs to survey their graduates. In 2014, the Association of Family Medicine Residency Directors (AFMRD) and the American Board of Family Medicine (ABFM) convened a steering committee to identify the priorities for a national graduate survey, with the idea of using data collected for ABFM business purposes to fulfill the ACGME graduate survey requirement.

    The survey was developed based on items in the ABFM’s certification and recertification questionnaires. The topic list was reviewed by several family medicine organizations and the authors used feedback from each organization to map the draft survey. After multiple reviews and revisions, the first pilot survey was emailed to a national group of recent residency program graduates. After review and revision of a second pilot survey, the final survey was completed and included four content areas: Practice and Work Schedule, Adequacy of Training and Scope of Practice, Satisfaction, and Professional Activity. The inaugural survey was conducted in 2016 with data fed back to residencies in early 2017.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to:
    Amanda K. H. Weidner, MPH, University of Washington School of Medicine, Department of Family Medicine, Box 354696, Seattle, WA 98195-4696, 206.221.4108, fax 206.685.0610, aweidner @ uw.edu


    Study Reviews Resident and Residency Characteristics Associated with Population Health Management

    Thursday, November 9, 2017  Using data collected from the American Board of Family Medicine (ABFM) as part of the certification examination application, the authors, Erika K. Schuster, BS and Lars E. Peterson, MD, PhD assessed residents’ Population Health Management (PHM) preparedness via a single, self-reported question.

    Results from 6,135 residents from 442 family medicine residencies indicated that 69% reported being extremely or moderately prepared to perform PHM. There were no residency program characteristics associated with PHM preparedness; however, independent resident characteristics associated with reported preparedness including being an international medical graduate (IMG) and of Hispanic ethnicity. In addition, residents who reported feeling prepared to perform PHM were also likely to report feeling prepared to use electronic health tools to manage population health, to lead quality improvement projects, and to provide care in different settings. These results support earlier work that found IMG family physicians were more likely to perform PHM in practice.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to:
    Lars E. Peterson, MD, PhD, 1648 McGrathiana Parkway Suite 550, Lexington, KY 40511. 859-269-5626. Fax: 859-335-7501. lpeterson @ theabfm.org


    ABFM Makes Certification Available for AOA 3-Year Residency Trained Family Physicians

    Friday, October 20, 2017  The American Board of Family Medicine (ABFM) is pleased to announce a change to the certification requirements, which will now allow osteopathic family physicians who have completed three years of accredited family medicine residency training in either AOA programs or AOA programs that have received ACGME preaccreditation or initial accreditation to apply for certification with the ABFM. The eligibility period for osteopathic family physicians will begin in 2018 and conclude at the end of 2022.

    The current ABFM certification requirements combined with the transition to a single accreditation system could have made potential residents in an AOA-accredited family medicine program seeking ACGME accreditation ineligible for ABFM certification, subsequent ACGME subspecialty training, and ABFM certificates of added qualification. By the end of 2017, AOA-accredited programs applying for ACGME accreditation must submit applications for pre-accreditation, but it may take some time for programs to become fully accredited. There is the possibility that some programs will not become fully accredited before the transition period ends in 2020. Under current ABFM policies those family physicians seeking certification must complete the last two years of training in an ACGME-accredited family medicine program to be eligible for ABFM certification. Additionally, any candidate seeking to obtain an ABFM certificate of added qualification (CAQ) must be currently certified with the ABFM in family medicine. Therefore, current ABFM requirements could have placed family medicine residents in a state of ineligibility for both fellowship training and subspecialty certification barring changing the requirements.

    Physicians who trained or completed training in a 3-year AOA-accredited family medicine residency or an AOA program that has received ACGME preaccreditation or initial accreditation will be eligible to apply for initial certification with the ABFM provided the requirements for certification entry are met. The eligibility period for initial certification for those meeting these requirements will begin in December this year and conclude December 31, 2022. The certification entry details will be made available on the ABFM website by the end of November 2017 and osteopathic family physicians who meet the requirements will be able to seek entry into the certification process at the beginning of December.

    The ABFM Board of Directors approved this change in certification requirements at the 2017 Annual Meeting, and in accordance with the American Board of Medical Specialties (ABMS) requirements, the change in ABFM certification requirements was presented to and approved by the ABMS Committee on Certification (COCERT).

    For additional information, click here.


    Tammy Chang, MD, MPH, MS Selected as 2017 NAM Puffer ABFM Fellow

    Monday, October 16, 2017  The National Academy of Medicine (NAM) has selected Tammy Chang, MD, MPH, MS as the 2017 James C. Puffer, MD/American Board of Family Medicine Fellow. Dr. Chang is an assistant professor in the Department of Family Medicine at the University of Michigan, Ann Arbor. She is one of five outstanding health professionals selected for the class of 2017 NAM Fellows.

    Dr. Chang received her undergraduate degree from the University of Michigan with honors in Cellular and Molecular Biology and Zoological Anthropology. She also received her medical degree and master of public health degree in health policy and management from the University of Michigan. Dr. Chang completed residency training and served as co-chief resident in the Department of Family Medicine at the University of Michigan and is an alumna of the University of Michigan Robert Wood Johnson Foundation Clinical Scholars program. She has received several national awards including the Academy Health Presidential Scholarship for New Health Services Researchers, the North American Primary Care Research Group Distinguished Trainee Award, and the Society of Teachers of Family Medicine Distinguished Paper Award.

    As a Puffer/ABFM/NAM Anniversary Fellow, Dr. Chang will receive a research stipend of $25,000. Named in honor of James C. Puffer, M.D., president and chief executive officer of the ABFM, the fellowship program enables talented, early career health policy and science scholars in family medicine to participate in the work of the Academies and further their careers as future leaders in the field. The James C. Puffer, MD/ABFM Fellowship was established under the NAM Fellowship program in 2011.

    NAM Anniversary Fellows continue their main responsibilities while engaging part-time over a two-year period in the Academies' health and science policy work. A committee appointed by the president of the Institute of Medicine (IOM) selects fellows based on their professional accomplishments, potential for leadership in health policy in the field of family medicine, reputation as scholars, and the relevance of their expertise to the work of NAM and the IOM.


    ABFM Selects Warren Newton, MD, MPH as New President and CEO

    Thursday, October 12, 2017  Dr. NewtonThe American Board of Family Medicine's (ABFM) Board of Directors has selected Warren Newton, MD, MPH to become its next President and Chief Executive Officer, succeeding Dr. James C. Puffer upon his retirement. Dr. Newton will serve in the position of President and CEO Elect beginning July 1, 2018 until Dr. Puffer’s retirement at the end of 2018. Upon assuming the role of President and CEO on January 1, 2019, Dr. Newton will oversee the ABFM, as well as the ABFM Foundation and Pisacano Leadership Foundation.

    Dr. Newton is currently Executive Director of the North Carolina Area Health Education Center (NC AHEC), a national leader in practice redesign, continuing professional development, health careers programming, and innovation in graduate medical education, and Vice Dean of the School of Medicine at the University of North Carolina (UNC). From 1999-2016, he served as the William B. Aycock Professor and Chair of Family Medicine at UNC.

    Dr. Newton has been a personal physician for 33 years, working in a variety of settings, including the UNC Family Medicine Center, the Moncure Community Health Center, and the Randolph County Health Department. In the 1990s, he founded the first hospitalist program at UNC Hospitals and helped reorganize family medicine obstetrics into a maternal child service. Over the past 15 years, he has led practice transformation initiatives at the practice, regional and statewide levels; North Carolina AHEC now provides support in health information technology, PCMH and quality improvement for over 1,200 primary care practices.

    As an educator, Dr. Newton served as residency director at UNC from 1992-1997; since 2004, he has co-led the I3 collaborative of 24 primary care residencies focused on clinical transformation in the residency practices. He has also taught extensively in medical school and fellowship programs and served as Vice Dean of Medical Education at the University of North Carolina from 2008-2013, during which he led an LCME review, expanded the school, established satellite campuses, developed new curricula in professionalism and population health and expanded the enrollment of underrepresented minorities. Dr. Newton’s scholarship has focused on the organization and effectiveness of health care; he has over 140 peer reviewed publications, including over 80 published with students, and has been principal investigator on grants totaling more than $45,000,000. Finally, from 2012 to 2017, he served on the Board of Trustees of the North Carolina State Health Plan, responsible for the health and health care of approximately 700,000 state and county employees and retirees. In 2016, he served as Senior Policy Advisor to the North Carolina Secretary of Health and Human Services, helping to prepare the Medicaid 1115 innovation waiver, plan rural residency expansion and develop quality metrics for Medicaid.

    “Warren Newton’s extraordinary service to the discipline of family medicine and his commitment to improving health has been a core value that has guided every aspect of his professional work over the last three decades,” said Elizabeth G. Baxley, MD, Professor of Family Medicine at Brody School of Medicine and Chair of the ABFM Board. “I have had the privilege of working with Warren at the state and national level and can attest to his dedication to continuous improvement and innovation in clinical care and education, as well as his drive to strengthen the discipline of family medicine to serve the American public. He is truly a transformative leader, and the ABFM Board of Directors is confident in his abilities to ensure that our certification programs are relevant and worthwhile to both clinicians and patients.”

    Continuously board certified in family medicine since 1987, Dr. Newton served on the ABFM Board of Directors from 2007-2013, including his term as Board Chair in 2011-12. He currently serves as a Director on the ABFM Foundation Board of Directors. Dr. Newton also brings experience working with the American Board of Medical Specialties, where he serves as a member of the ABMS Committee on Continuing Certification, including a term as one if its first chairs in 2014.

    Additional national roles in which Dr. Newton has served include President of the Association of Departments of Family Medicine and Founding Chair of the Council of Academic Family Medicine. He is currently a member of the Liaison Committee of Medical Education and represents the ABFM at the National Academy of Medicine’s Global Forum on Innovation in Health Professional Education.

    Dr. Newton graduated from Yale University in 1980 and Northwestern Medical School in 1984. After residency and chief residency at the University of North Carolina, he completed the Robert Wood Johnson Clinical Scholars Program and an MPH at the UNC Gillings School of Global Public Health. In 2012-13, he was selected as a Society of Teachers of Family Medicine (STFM) Bishop Fellow, during which he also completed the American Council of Education Fellow’s program.

    “For nearly 50 years, the American Board of Family Medicine has served family physicians and the public with great distinction. I am delighted to serve the Board and family physicians across the country and honored to follow the outstanding leadership of Jim Puffer,” said Newton. “I have great admiration for the family physicians at the forefront of the care and the innovation that the American public needs. The Board is deeply committed to supporting them as they serve their patients and communities, and will continue to help develop the systems and tools needed to support them as they work continually to improve their practices. We are also committed to engagement with our partners—patients and families, other specialties, other professions, other organizations and payers—who share our vision of the need for dramatic improvement in health and health care for the American people.”


    Study Investigates Debate Over Length of Family Medicine Residency Training

    Friday, September 8, 2017  Using data collected from the American Board of Family Medicine (ABFM) as part of the resident certification examination application, the authors, Tomoko Sairenji, MD, MS, Mingliang Dai, PhD, Aimee R. Eden, PhD, Lars E. Peterson, MD, PhD, and Arch G. Mainous, III, PhD, assessed the proportion of family medicine residency graduates intending to pursue fellowship training or another year of residency training if it were available.

    Results from the 6,235 questionnaires completed by family medicine residents indicated 17% intended to enroll in a fellowship, while 54.2% were “not at all likely” to extend residency training. Forty-six percent of those intending a fellowship were “not at all likely” to extend training.

    The study found a disconnect between fellowship intention and desire for another year of residency training, furthering the existing debate over the ideal length of family medicine residency. The discussion on length of training centers mostly on whether family medicine training should be expanded from three to four years, or shortened to two. Fellowships offer a different strategy for obtaining specific skills and expertise; however, some graduates of family medicine fellowships then disappear from the primary care workforce.

    The complete article, Fellowship or Further Training for Family Medicine Residents?, may be found here.

    Inquiries and correspondence should be addressed to Dr. Sairenji, 1959 NE Pacific St, Seattle, WA 98195-6390. 206-685-7942. Fax: 206-543-3821.
    sairenji @ uw.edu


    A Look at Primary Care Effectiveness...

    Friday, September 8, 2017  Robert L. Phillips, Jr, MD, MSPH, Vice-President of Research and Policy for the American Board of Family Medicine (ABFM), discusses the shift in family medicine residents joining larger health systems over small or solo family medicine practices.

    The findings regarding the increase of primary care physicians moving to larger health systems are concerning as a recent study showed this trend reduces the ability of primary care to deliver the functions associated with better outcomes seen in small, physician-owned practices. Growing evidence indicates that family medicine teams that increase practice scope support better primary care and improve outcomes. Preliminary analysis of the 2016 ABFM Graduate Survey also suggests that broad scope practice may protect against burnout.

    The complete article can be found here.

    Inquiries and correspondence should be addressed to:
    Dr. Phillips, American Board of Family Medicine, 1648 McGrathiana Pkwy, Suite 550, Lexington, KY 40511.
    bphillips @ theabfm.org


    Choosing Financial Support for Service Commitments

    Friday, September 8, 2017  The authors, Julie Phillips MD, MPH; Lars E. Peterson MD, PhD; Bo Fang PhD; Iris Kovar-Gough MA, MLIS; Robert L. Phillips Jr. MD, MSPH, used de-identified data from the American Board of Family Medicine (ABFM) examination registration questionnaire, which is required of all residents applying for board certification. Results showed 4.4% residents had either obtained military support or enrolled in the National Health Service Corps (NHSC).

    A majority (82%) of graduating family medicine residents have educational debt – 58% graduating with more than $150,000. Family physicians today have opportunities to avoid accruing debt or have loans paid with a service commitment; however, of the 6,231 residents studied, only 271 (4.4%) had either obtained military support or enrolled in the NHSC. There was only a small percentage difference in men (4.2%) versus women (2.2%) who had enrolled. Despite the low numbers, a 2014 survey found that 62% of medical school graduates in primary care intended to pursue loan repayment through the Public Service Loan Forgiveness (PSLF) program.

    The complete article, How Many Graduating Family Medicine Residents Have Chosen Financial Support for Service Commitments?, may be found here.

    Inquiries and correspondence should be addressed to Dr. Julie Phillips, 788 Ser¬vice Road, Room B114, East Lansing, MI 48824. 616-234-2672. Fax: 616-234-2638.
    julie.phillips @ hc.msu.edu


    Scope of Practice Among Family Physicians

    Friday, September 8, 2017  While some studies have shown that family physicians’ scope of practice may be shrinking, a recent study, which included researchers from Oregon Health & Science University and the American Board of Family Medicine, indicates graduates of residencies engaged in significant educational redesign report a broad scope of practice.

    The research team surveyed 507 graduates involved in the P4 project 18 months after residency between 2008-2014. The Preparing the Personal Physician for Practice (P4) project was designed to improve the graduate medical education of family physi¬cians so they were better prepared to be outstanding personal physicians and work in emerging new mod¬els of care. Their report assessed 25 clinical activities and 30 procedures. Compared to national data, P4 graduates reported higher rates for vaginal deliveries, adult in-patient care and nursing home care in their practice. The distribution of P4 graduates by region was14% West, 17% Midwest, 24% Southwest, 11% Southeast, and 26% Northeast. No statistical differences were found across P4 innovation implementa¬tion groups for sex, race, communi¬ty size, underserved practice setting, mean work hours/week, or visit vol¬ume

    Graduates exposed to innovations that lengthened training as part of the P4 project, compared to standard training length, were also more likely to include adult hospital care, adult ICU care and newborn resuscitation in their practice.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to:
    Dr. Eiff, Oregon Health & Science University-Department of Family Medicine, 3181 SW Sam Jackson Park Road, Portland, OR 97239. 503-494-6610. Fax: 503-494-4496
    eiff @ ohsu.edu


    American Board of Family Medicine Elects New Officers and Board Members

    Thursday, May 25, 2017  The American Board of Family Medicine (ABFM) is pleased to announce the election of four new officers and four new board members. The new officers elected at the ABFM’s spring board meeting in April are: Elizabeth Baxley, MD of Greenville, North Carolina elected as Chair; Jerry Kruse, MD of Springfield, Illinois as Chair-Elect; Montgomery Douglas, MD of West Hartford, Connecticut as Treasurer, and Joseph Gravel, Jr., MD of Lawrence, Massachusetts as Member-at-Large, Executive Committee. In addition, the ABFM welcomes this year’s new members to the Board of Directors: Beth Bortz of Richmond, Virginia; Lauren Hughes, MD, MPH, MSc of Philadelphia, Pennsylvania, John Mellinger, MD of Springfield, Illinois, and Daniel Spogen, MD of Sparks, Nevada.


    American Board of Family Medicine’s Physician Quality Reporting System Deadline passes with Outstanding Numbers

    Tuesday, April 18, 2017  The American Board of Family Medicine (ABFM) is pleased to announce over 1600 clinicians submitted data to the Physician Quality Reporting System (PQRS) through the ABFM’s online submission process and through the PRIME Patient Data Registry.

    The Physician Quality Reporting System (PQRS) is a quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time. By reporting on PQRS quality measures, individual EPs and group practices can also quantify how often they are meeting a particular quality metric.

    The PRIME Registry is a population health and performance improvement tool for clinicians and practices. It extracts patient data from the physician’s electronic health record (EHR) and turns it into actionable measures.  PRIME is registered as a Qualified Clinical Data Registry and Specialty Registry open to all Primary Care Physicians—Family Medicine, Pediatrics, Internal Medicine, Obstetricians/Gynecologists, as well as Physicians Assistants and Nurse Practitioners.


    Updates to the ABFM Exam Prep App for iPhones

    Monday, April 10, 2017  In recent weeks, some physicians have been experiencing problems with the ABFM Exam Prep app. Apple pushed two updates out to iPhone users. These updates caused our app to begin to malfunction in various ways. The developers have updated the app and this new version was released in the first week in April. The new version works quite well when users have updated both their operating system and the Exam Prep app, but iPhone users may still experience bugs when only one is updated.


    ABFM Statement Regarding Executive Order Travel Ban

    Friday, February 3, 2017  Please download the statement [PDF 76KB] from the American Board of Family Medicine regarding the recently signed Executive Order titled Protecting the Nation from Foreign Terrorist Entry into the United States, which restricted travel into the U.S. from seven specified countries.


    ABFM Launches Continuous Knowledge Self-Assessment (CKSA)

    Tuesday, January 17, 2017  The ABFM’s new Continuous Knowledge Self-Assessment (CKSA), a self-assessment and lifelong learning activity, will launch on January 19, 2017. The CKSA is designed to deliver a set of 25 questions each quarter. There is no passing or failing for this activity. After independently completing 100 CKSA questions, a performance report will be provided to the physician summarizing their results by certification examination blueprint categories to help family physicians identify gaps in their knowledge.

    What you need to know:

    • Access the CKSA via your portfolio (and soon your mobile app!), and the program will guide you through answering each question in order.
    • Each multiple-choice question (MCQ) in the CKSA will require a single best answer response. The correct answer will be provided after each question is answered along with a critique describing the rationale for the correct option. A comment feature will allow family physicians to share their opinions on concepts relating to each question.
    • A physician may start, stop or resume the assessment questions at any time during the 3-month period.
    • Complete all 25 questions during the 3-month activity window and receive 2.5 certification points that can be applied to the 50 points required for the 3-year stage.
    • Complete all 25 questions for each of the four quarters throughout the year and receive a total of 10 certification points, satisfying the minimum 1 Knowledge Self-Assessment (KSA) requirement for that stage.
    • Continuously participate in the CKSA throughout the entire 3-year certification stage and receive 30 certification points, leaving only a Performance Improvement activity needed to complete family medicine certification requirements.

    The CKSA will be added to the suite of options for completing the self-assessment requirement for Continuous Certification. The CKSA is designed to help physicians identify their personal strengths and weaknesses in medical knowledge and clinical decision-making within the framework of broad spectrum family medicine, so that they can target subsequent continuing medical education in those areas. The questions will be developed using the certification examination blueprint and will be similar in format to those seen on the certification examination. The performance report provided once a physician has participated in 100 questions, four different CKSA quarters, will estimate how a physician would likely score on the certification examination, estimate one’s probability of passing the certification examination, and compute an index related to how accurate a physician’s confidence was regarding the correctness of their answers.

    Completing the 25 questions can be done throughout the 3-month quarter in a manner that best suits the individual physician i.e. questions can be completed whenever and wherever it is convenient for the physician. If a physician prefers to answer two questions per week over morning coffee, then an automatic reminder can be set up to deliver two questions a week. On the other hand, those that wish to complete a small number of questions per month can receive monthly reminders to answer questions. If one wishes to answer all 25 questions at one sitting while on a long road trip over the summer (while riding in the passenger’s seat of course!), that can be accommodated as well. Overall, the manner of the CKSA administration is intended to be both more user-friendly, as well as more continuous in nature.