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    Newsletter December 2018

    Monday, December 24, 2018   The ABFM is pleased to provide you access to the December issue of The Phoenix newsletter. This shorter newsletter is emailed to all Diplomates four times per year (we no longer deliver copies via US Mail). To view the online version, click here.

    You may have interest in the following pieces included with this newsletter:


    If you have any questions or comments regarding information contained in this newsletter, please contact us at help@theabfm.org


    ABFM seeks Senior Vice President of Research and Policy

    Thursday, November 29, 2018   The American Board of Family Medicine (ABFM) seeks a Senior Vice President of Research and Policy to lead its research enterprise. The major responsibilities of this position will be to:

    • Lead the next phase of the development of the ABFM research enterprise,
    • Co-lead the ABFM's Center for Professionalism and Value in Health Care
    • Coordinate and develop ABFM Career Development activities, including the ABFM Scholars, Pisacano Scholars and the Puffer fellows.
    • Help develop and implement a national strategy to engage clinically integrated health systems on behalf of the family physicians they employ.

    The Senior Vice-President for Research and Policy will be a member of the senior leadership team of the ABFM. This is an executive position, with responsibility for developing and implementing policy; the SVP will speak as a representative of ABFM with partners across Family Medicine, other specialties and other professions. He/She will report directly to the President and CEO, attend ABFM Board meetings and work collaboratively with the Executive Vice President, the Executive Director of the Center on Professionalism and Value in Health Care, the Chief Financial Officer, and the Vice President of Operations. The Vice President of Research, the growing ABFM research team and other career development program staff will report to the Senior Vice-President for Research and Policy.


    The American Board of Family Medicine is a leading specialty board. With over 92,000 Diplomates, the American Board of Family Medicine is third largest of the 24 specialty boards in the American Board of Medical Specialties. ABFM has a longstanding reputation for innovation and leadership among the specialty Boards, and was the first Board to require ongoing recertification, to include other specialties on its board and one of the first to develop a portfolio devoted to quality improvement and include public members. Now, with new executive leadership and a bold new strategic plan, the American Board of Family Medicine is poised to launch significant changes in its certification program, build the infrastructure of the discipline and support the role of family physicians and primary health care in implementing the quadruple aim. Additional and ongoing focus on research related to diplomates and their practice will be a cornerstone of this effort.

    The core of the work of ABFM is continuous certification; this includes monitoring the professionalism of our Diplomates, providing ongoing knowledge self-assessment exercises, independent assessment of cognitive expertise and supporting quality improvement. In addition to ongoing certification, ABFM is a sponsor of the ACGME Family Medicine Residency committee, develops leaders in Family Medicine through the ABFM Scholars and the Pisacano and Puffer fellowships, and also serves the discipline through sponsorship of the Journal of the American Board of Family Medicine (JABFM) and support of the Annals of Family Medicine. The ABFM Foundation supports education and research across the discipline.

    Over the last decade, the ABFM has also developed a substantial research enterprise. The ABFM has always been a leader within the ABMS community in research on psychometrics and assessment. Adding to this stream of work, ABFM has invested heavily in its database which tracks the careers and practices of our Diplomates over their careers. Led by Lars Peterson MD PhD, and in partnership with the Robert Graham Center and many other national collaborators, the ABFM has led studies of the effectiveness of board certification and changes in the scope and organization of the practices of family physicians. In the last year, highlights have included ongoing development of quality metrics that capture better the contributions of Family Medicine to health, the association of burnout among family physicians with employment and more narrow scope of practice, and the outcomes of residency programs across the country. A large proportion of publications by ABFM staff are co-authored by medical students, residents or senior fellows.

    In July, 2018, ABFM launched the Center for Professionalism and Value in Health Care in Washington, DC, led by Executive Director Bob Philips, MD MSPH. ABFM believes that health care in the US is in the midst of transformational change, and that professional self-regulation and the public trust are at risk. The ABFM has long worked at the forefront of professional standard setting, self-regulation and social accountability through rigorous professional standards and support of the health of the public. ABFM now wishes to provide focus and new emphasis on this work. In addition to consolidating the ABFM's current work in Metrics that Matter, the PRIME registry, and the PHATE tool, the new Center will also educate opinion leaders, policy makers and the public about the potential of professional self-regulation and standards for improving the health of the public. The Center welcomes collaboration with all others interested in professionalism and value in health care, including other specialty boards, other professions and other organizations interested in working together on this common ground.

    ABFM's research enterprise is thus a key driver of its future activity, both in terms of support of its Diplomates and its service to the discipline and the profession. The Senior Vice President for Research and Policy will play a major role in its ongoing development. Working closely with both the Lexington research team and the Center in Washington, this new leader will develop and implement the strategy for further development of research in ABFM. This individual will build the infrastructure necessary for extramural funding of research, and use both ABFM Foundation and extramural funding to develop ABFM's research portfolio. Key roles will include supporting development of the Lexington research team and cultivating research and policy partners from universities, research institutes, government and payers. He/She will lead the development of the PRIME registry, support the development, testing and implementation of meaningful measures, and participate in developing a strategy to engage with clinically integrated systems. Finally, in keeping with ABFM's commitment to developing leadership for discipline, the SVP will work with existing program leadership to coordinate the growth and development of ABFM's career and leadership development activities.

    We anticipate that the SVP will play a personal role in convening national initiatives, cultivating research and policy partners, conducting both intramurally and extramurally funded research, and supporting medical students, residents and senior fellows in their research. The SVP will also play a senior executive role in the ABFM, attending all executive meetings, engaging with the ABFM Board of Directors and speaking for ABFM ex officio.

    Application Process

    The successful candidate will have substantial leadership experience in research and policy, with an excellent track record in extramural research and leadership at the national level. He/She will have excellent skills in oral and written communication, developing colleagues and cultivating partnerships within Family Medicine and across other specialties and professions. Living in Washington DC is necessary, with substantial national travel necessary. Clinical practice desirable. Start date as soon as possible, but flexible. Full ABFM benefits; salary dependent on experience and is negotiable.

    Letters of interest and curriculum vitae are due by January 15, 2019; please submit applications to Ms. Rempfer. Finalists will be asked to interview with Lexington and Washington staff and to present their work.

    Short descriptions of the activities of the Board and the current research portfolio are available for review. For further information, please contact Warren Newton, MD MPH, President and CEO of ABFM.


    Progress in Racial and Ethnic Diversity Among Family Physicians

    Monday, November 12, 2018   Racial and ethnic minority physicians are more likely to practice primary care in impoverished areas and in regions experiencing shortages. The Association of American Medical Colleges has worked for several years to improve access to primary care for underserved populations.

    Researchers from the American Board of Family Medicine (ABFM) aggregated racial and ethnic demographic data provided by family physicians and found that efforts to increase diversity among the physician workforce seems to have been effective for some racial and ethnic groups but not all.

    The data were collected from over 66,000 board certified family physicians and found that compared with the US population, ABFM Diplomates are more likely to be Asian, Native Hawaiian, or Pacific islander, and less likely to be African American, Native American / Alaska Native, or Hispanic/ Latino. Non-Hispanic white Diplomates are more representative of the US population.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to: Michael R. Peabody, PhD, 1648 McGrathiana Pkwy, Ste 550, Lexington, KY 40511.


    More Rural Family Medicine Practices Enrolled in Practice Transformation Networks

    Monday, November 12, 2018   A recent study by researchers at the American Board of Family Medicine found Practice Transformation Networks (PTNs) enrolled a higher proportion of rural family medicine practices than are represented across the general workforce. The variation in state enrollment of family physicians is likely due to a few reasons, including PTNs that are based in closed health systems, a shortened recruitment timeline, and competition from other demonstration projects or related, disqualifying practice affiliations.

    The researchers assessed the enrollment of rural practices in PTNs using 2016 Transforming Clinical Practice Initiative (TCPI) enrollment data and American Board of Family Medicine recertification examination registration data from 2013 to 2016. The Centers for Medicare and Medicaid Services' (CMS) TCPI is one of the largest federal investments to date designed to help clinicians achieve large-scale health transformation and achieve the Triple Aim of improving the patient experience, improving the health of the population, and reducing the costs of healthcare.

    Future studies will examine final enrollment and practice characteristics as CMS makes these data available. The complete article can be found here.

    Correspondence and inquiries should be addressed to: Robert L. Phillips, Jr, MD, MSPH, American Board of Family Medicine, 1648 McGrathiana Pkwy, Suite 550, Lexington, KY 40511.


    ABFM's Family Medicine Certification Longitudinal Assessment (FMCLA) Pilot Approved

    Thursday, November 8, 2018   We are pleased to announce the examination option Longitudinal Assessment Pilot has been approved by the American Board of Medical Specialties' Committee on Continuing Certification. All family physicians who are in their 10th year of their certification cycle in 2019 and in good standing with continuing certification will be eligible for the pilot.

    Eligible Diplomates will be able to sign-up for the pilot beginning December 7, 2018. The last day to begin a new application for FMCLA is March 1, 2019. More details will be available soon.


    Newsletter October 2018

    Friday, October 26, 2018   The ABFM is pleased to provide you access to the October issue of The Phoenix newsletter. This shorter newsletter is emailed to all Diplomates four times per year (we no longer deliver copies via US Mail). To view the online version, click here. You may have interest in the following pieces included with this newsletter:

    If you have any questions or comments regarding information contained in this newsletter, please contact us at help@theabfm.org


    Kameron Matthews, MD, JD, FAAFP Selected as 2018 NAM Puffer ABFM Fellow

    Wednesday, October 17, 2018  The National Academy of Medicine (NAM) has selected Kameron Matthews, MD, JD, FAAFP as the 2018 James C. Puffer, MD/American Board of Family Medicine (ABFM) Fellow. Dr. Matthews currently serves as Acting Deputy Under Secretary of Health for Community Care at the Veterans Health Administration in Washington, DC. She is one of three outstanding health professionals selected for the class of 2018 NAM Fellows.

    Dr. Matthews earned her medical degree from Johns Hopkins University and her law degree from the University of Chicago. She completed her residency in Family Medicine at the University of Illinois at Chicago. Dr. Matthews has focused her career on underserved patient populations, having worked as a staff physician at Cook County Jail and with Erie Family Health Center, a large community health center also in Chicago. She most recently served as Chief Medical Officer of Mile Square Health Center within the University of Illinois Hospital and Health Sciences System. Dr. Matthews’ honors and awards include the National Medical Quality Forum's 2017 40 Under 40 Leaders in Minority Health, 2015 National Medical Association Council for the Concerns of Women Physicians Emerging Trailblazer Award, the 2015 NACHC Health Professions Education and Training Award, and the 2015 Congressional Black Caucus Foundation Health Braintrust Congressman Louis Stokes Public Health Advocate Award.

    Dr. Matthews serves as a member of the advisory board of the National Medical Quality Forum, a founding board member of Physicians for Criminal Justice Reform, a member of the alumni council of National Medical Fellowships, and an analyst with PolicyPrescriptions.org. Her career interests focus on access to care, pipeline workforce development, and healthcare disparities. As a passion outside of work, she co-directs the Tour for Diversity in Medicine, an initiative seeking to bring premedical enrichment activities to minority high school and undergraduate students across the country.

    As a Puffer/ABFM/NAM Anniversary Fellow, Dr. Matthews 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.


    American Board of Family Medicine Creates Examination Alternative Option for 2019

    Tuesday, October 9, 2018  The American Board of Family Medicine (ABFM) is pleased to announce a pilot program to begin in January 2019 that will assess the value and feasibility of a longitudinal assessment option to the 10-year secure examination. Jerry Kruse, MD, Chair of the ABFM Board of Directors, announced this news today to family physicians attending the 2018 American Academy of Family Physicians Congress of Delegates in New Orleans. Physicians who are current with continuous certification and are due to take the examination in 2019 would be eligible to participate in the pilot. Dr. Kruse stated, "based on the popular Continuous Knowledge Self-Assessment (CKSA) platform, the longitudinal assessment pathway will deliver 25 questions online each quarter to those Diplomates who choose this new option. This approach is more aligned with the ongoing changes in medicine and draws upon adult learning principles, combined with modern technology, to promote learning, retention and transfer of information. Over time, we will be able to assess the core clinical knowledge of board-certified family physicians and recognize the vast majority who work to keep up to date to take care of their patients."

    This summer, the ABFM contracted with the University of Florida to conduct an independent, randomized survey of Diplomates who recently took the 10-year examination, to inquire about their interest in a variety of options to the exam. The most popular choice voiced by respondents was for a longitudinal assessment model.

    A combination of physician experience with the CKSA platform, feedback from Diplomates over time, the independent survey, and information gleaned from the experience of other ABMS boards, all contributed to ABFM's design of the new online, longitudinal assessment process that will serve as the exam option for this pilot.

    The ABFM has two years of Diplomate experience with the CKSA platform. Feedback from the more than 24,000 family physicians who have participated in CKSA has consistently shown that this model provides continuous, systematic learning and identification of knowledge gaps, and is highly rated as a useful and convenient platform.

    "We believe that longitudinal assessment can meet many of the needs and desires we have heard voiced by family physicians," said Dr. Warren Newton, incoming President and CEO of ABFM. "It will provide questions on a regular, longitudinal basis, in a format that is much more convenient—a few questions at a time, in the place and time of your choice. You may use clinical references during the assessment, much like you do in practice. You will not need to travel to a test center, nor spend additional time and money on preparatory courses. And, we believe that longitudinal assessment will support your desire for continued learning and practice improvement."

    The pilot program was approved by the ABFM Board of Directors earlier this month. In November, it will be presented for approval to the American Board of Medical Specialties' (ABMS) Committee on Continuing Certification. More details will be forthcoming after this final approval step from ABMS. Throughout the pilot, regular feedback will be sought from participants, which will be used to inform program modifications for the future.


    High Educational Debt Affects Family Medicine Residents' Practice and Fellowship Intentions

    Tuesday, October 2, 2018  A recent study conducted by researchers from Michigan State University and the American Board of Family Medicine (ABFM) indicates family physicians with high debt ($150,000-$249,999) are less likely to pursue jobs with government organizations, such as work for Federally Qualified Health Centers. Those with high or very high debt (>$250,000) were also less likely to choose academic practice or a geriatrics fellowship.

    The authors completed a cross-sectional secondary analysis of 2014 and 2015 ABFM examination registration questionnaire data and ABFM administrative data. They used multivariate logistic regression to determine whether educational debt was associated with graduating residents' practice (ownership and type) and fellowship intentions.

    The increase in educational debt for medical students has been a growing concern for medical educators, policymakers, and students. This study demonstrates that high debt may be worsening shortages of academic family physicians and geriatricians; and that physicians with high debt may be less likely to care for underserved populations. Previous studies also associate high educational debt with resident burnout, which may affect career choices.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to:

    Julie Phillips
    Sparrow-MSU Family Medicine Residency Program
    200 E Michigan Avenue, Suite 245
    Lansing, MI 48912

    email: Julie Phillips


    New Center for Professionalism & Value in Health Care to be opened in Washington, DC

    Monday, July 9, 2018  Robert Phillips, MD MSPHThe American Board of Family Medicine (ABFM) and the ABFM Foundation are pleased to announce the establishment of the Center for Professionalism and Value in Health Care based in Washington, D.C. The Center will be led by Robert Phillips, MD MSPH, who has been named as its founding Executive Director.

    “Health care in the United States is in the midst of transformational change; professional self-regulation and the public trust are at risk. To meet this challenge, the ABFM Foundation has decided to make a strategic investment in the creation of the Center with the ultimate goal of dramatically improving health and health care,” said ABFM President and CEO Elect Warren P. Newton, MD, MPH.

    The new Center aims to create space in which patients, health professionals, payers, and policymakers can work to renegotiate the social contract. “The social contract between health care professionals and the public gives clinicians the privilege of self-regulation in exchange for responsibility to act in the best interest of patients. This contract is fraying as increased employment of clinicians creates pressures to serve business interests over those of patients. The erosion of autonomy, strain of regulation, and exploding reporting burden is producing unprecedented levels of burnout,” says Dr. Phillips. “It has gotten so bad,” continues Phillips, “that physicians are unwittingly asking many state legislatures to remove long-standing mechanisms of self-regulation and public accountability. We cannot afford to have the public question health professionals’ willingness to be accountable, and patients cannot afford our surrender of that role to payers and policymakers.”

    The Center will seek to define value across the healthcare spectrum, reaching beyond medicine to engage the broader healthcare community as well as patients and families to consider what they believe professionalism and value mean, how to measure it, how to improve it, and how to engage and develop leaders. The Center welcomes collaboration with all others interested in professionalism and value in health care, including other specialty boards, other professions, and other organizations interested in working together on this common ground.

    “The selection of Bob Phillips to lead the Center is an outstanding choice,” says James C. Puffer, MD, President and CEO of the ABFM. “In his role as ABFM Vice President of Research and Policy, he helped the ABFM Research Department grow to become an influential source of information about the value of primary care. He also led the launch of the national PRIME Registry, which now helps primary care practices in 49 states liberate data from their electronic health records, thus enabling easier monitoring and improvement of quality, measure reporting, and completion of certification requirements. He was instrumental in the creation and successful launch of the ABFM PHATE tool, which helps practices understand how their patients are affected by social determinants of health and how to meet their needs, as well as to support enhanced reimbursement.”

    Dr. Phillips graduated from the University of Florida College of Medicine and completed residency training and a health services research fellowship at the University of Missouri. Prior to coming to the ABFM, he directed the Robert Graham Center for Policy Studies in Primary Care. Dr. Phillips is an elected member of the National Academy of Medicine and was a Fulbright Specialist to the Netherlands and New Zealand. He currently serves on the National Committee on Vital and Health Statistics, is a Professor at Georgetown University and Virginia Commonwealth University and maintains a continuity family medicine practice in Virginia.


    Newsletter June 2018

    Thursday, June 14, 2018  The ABFM knows your time is valuable, and we want to share information with you in a concise way. To assist with this, we’ve changed the format of our newsletter from a 16-page, twice yearly printed newsletter, to a shorter (6-page max) email-only delivered informational news piece. We hope to save both your time and the environment.

    The June 2018 edition of the Phoenix includes:

    • Clinical Status Self-Designation allows exemption from Performance Improvement requirement
    • Retired Physician Status allows entire certification history to be seen online
    • Enroll in PRIME Registry by July 31, 2018 to Utilize MIPS Reporting Service
    • ABFM Elects New Officers and Board Members
    • ABFM Selects Elizabeth G. Baxley, MD as New Senior Vice President

    To view the Flipping Book version, click here.


    American Board of Family Medicine Elects New Officers and Board Members

    Friday, May 18, 2018  The American Board of Family Medicine (ABFM) is pleased to announce the election of four new officers and three new board members. The new officers elected at the ABFM’s spring board meeting in April are: Jerry E. Kruse, MD, MSPH of Springfield, Illinois as Chair; John Brady, MD of Newport News, Virginia as Chair-Elect; Joseph W. Gravel, Jr., MD of Lawrence, Massachusetts as Treasurer; and Colleen Conry, MD of Aurora, Colorado as Member-at-Large, Executive Committee. In addition, the ABFM welcomes this year’s new members to the Board of Directors: Roger Bush, MD of Seattle, Washington; Gerardo Moreno, MD of Los Angeles, California, and Robert L. Wergin, MD of Milford, Nebraska.


    ABFM Selects Elizabeth G. Baxley, MD as New Senior Vice President

    Thursday, May 17, 2018  Baxley 2018The American Board of Family Medicine (ABFM) is pleased to announce the selection of Elizabeth G. (Libby) Baxley, MD, to become its next Senior Vice President beginning July 1, 2018.

    As Senior Vice President, Dr. Baxley’s major initial focus will be to lead all aspects of ABFM activity that relate to the experience of board certified family physicians with ABFM, including residency, the early clinical years, credentials, and communications.

    “A first priority of our efforts is engagement of diplomates as we work to make Family Medicine Certification as valuable as possible,” commented Warren Newton, MD, MPH, President and CEO Elect of the American Board of Family Medicine. “Dr. Baxley’s dedication to the discipline of family medicine and her passion for education will prove invaluable as she works with diplomates to evolve the process of continuing certification. I am pleased that she has accepted the challenge to enhance all aspects of diplomate experience with the ABFM.”

    A graduate of Clemson University, Dr. Baxley received a Doctor of Medicine from the University of South Carolina School of Medicine. She completed a family medicine residency at Anderson Family Practice Residency in South Carolina followed by the Faculty Development Fellowship at the University of North Carolina at Chapel Hill.

    She is currently the Senior Associate Dean for Academic Affairs and Professor of Family Medicine at the Brody School of Medicine at East Carolina University, where she has served since May 2012. In that role, she led a pioneering curriculum redesign with an emphasis on integration of training in health system science competencies: patient safety, quality improvement, population health, and interprofessional education. Brody was one of only 11 medical schools nationally to be selected by the AMA in their Accelerating Change in Medical Education initiative. Prior to that she spent 18 years at the University of South Carolina School of Medicine, serving as Family Medicine Residency Director, school-wide Director of Faculty Development, and Chair of the Department of Family and Preventive Medicine. Her work has focused heavily on health care delivery system redesign and teaching about patient safety and quality improvement. A faculty advisor for IHI Open School chapters at both USC and Brody SOM, she is also one of the co-founders of the I3 Collaborative, which has led residency practice redesign in primary care teaching practices across South Carolina, North Carolina, and Virginia.

    Dr. Baxley has an outstanding track record of leadership in Family Medicine, having taught and provided full-scope family medicine throughout the greater part of her 31-year career. In addition to her roles as a prior board member and board chair of the American Academy of Family Physician’s (AAFP) Advanced Life Support in Obstetrics (ALSO®) and the AAFP’s Residency Assistance Program Panel of Consultants, she served on the ABFM Board of Directors from 2013-2018. During her tenure on the board, she served on the certification, credentials, examination, and research and development committees, the latter of which she chaired. She became a member of the executive committee in 2016 after her election as Chair Elect and finished her final year on the board of directors as the Board Chair.

    Dr. Baxley has been honored with many distinctions including the American Academy of Family Physicians Exemplary Teaching Award and the James Halford Award for Leadership in Humane Education. In 2017 she was recognized by East Carolina University with a Woman of Distinction Award, and in 2016 and 2018 received the American Medical Women’s Association Gender Equity Award from medical students at Brody SOM.

    “This is a critical time in history for physicians to engage in meaningful dialogue around professional self-regulation and the value proposition of board certification,” said Baxley. “The ABFM board members and the professional staff in Lexington, Kentucky are committed to serving as partners with diplomates to demonstrate mastery and quality of care provided by family physicians throughout the US. I am excited about the prospect of working closely with individual physicians and family medicine organizations in an effort to enhance the value of family medicine certification into the future.”


    Broader Scope of Practice Is Associated with Lower Risk of Burnout

    Tuesday, May 15, 2018  Among physicians, family physicians report some of the highest levels of burnout. According to a new study, however, early career family physicians who provide a broader scope of practice report significantly lower rates of burnout. The study—a secondary analysis of the 2016 National Family Medicine Graduate Survey—found that those who practiced in more locations and performed a greater variety of procedures and clinical work were significantly less likely to report feeling burned out once a week or more. The strongest associations were in the practice of obstetrics and inpatient medicine, two areas with a decline in practice by family physicians in recent years. Specifically, the odds of reporting feeling burned out were 36 percent lower among those family physicians practicing obstetrics and 30 percent lower among those practicing inpatient medicine compared to their peers. Making house calls was also significantly associated with lower burnout. If future research confirms a causal relationship between scope of practice and physician wellness, the authors suggest it would allow for new policy levers and incentives for systems and physicians to improve health care as well as their own health.

    The complete article, Burnout and Scope of Practice in New Family Physicians, can be found here.

    Inquiries and correspondence should be addressed to: Lars E. Peterson, MD, PhD, American Board of Family Medicine, 1648 McGrathiana Parkway, Suite 550, Lexington, KY 40511


    Family Physicians Have Difficulty Finding Jobs that Allow Them to Deliver Babies

    Thursday, May 10, 2018  Studies have shown that poor access to maternity care has attributed to maternal and infancy mortality in the United States. Researchers at the University of Texas Health Science Center at San Antonio and the American Board of Family Medicine found that almost 60% of recent family medicine residency graduates reported that the opportunity to do deliveries was not available in the practice they joined and/or that lifestyle considerations influenced their decision not to include deliveries.

    The data, obtained from the 2016 Family Medicine National Graduate Survey, indicated that 87% of the 2000 plus respondents did not deliver babies. Removing barriers and creating viable work environments for family physicians who want to include obstetrics in their practice would increase access to maternity care and may decrease maternal morbidity.

    The complete article, Barriers Faced by Family Medicine Graduates Interested in Performing Obstetric Deliveries, can be found here.

    Inquiries and correspondence should be addressed to: Tyler W. Barreto, MD, 7703 Floyd Curl Drive MC 7795, San Antonio, TX 78229-3900.


    Family Physicians Face Challenges in Providing Advanced Maternity Care

    Wednesday, May 2, 2018  In 2010, fewer than 10% of family physicians provided maternity care, citing lifestyle, financial and liability concerns. A recent study from researchers at the American Board of Family Medicine (ABFM) demonstrated that family physicians who are trained to provide advanced maternity care (which includes surgical obstetrics) in their practices face additional challenges beyond lifestyle impact and the cost of insurance. Variability in maternity care training for family physicians, regional and institutional variation in hospital credentialing criteria, and strained relationships with obstetricians influence a family physician’s ability to practice advanced maternity care.

    Obstetricians provide the majority of maternity care in the United States in urban areas; however, family physicians often fill the gap in the maternity care workforce in rural America, including caring for high-risk pregnancies and providing other full spectrum maternity care services.

    The research used data from qualitative semi-structured interviews with 51 purposively sampled key stakeholders in family medicine maternity care. The group included family medicine-obstetrics fellowship directors, past fellows, and family medicine residency directors of programs with advanced maternity care training.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to: Aimee R. Eden, American Board of Family Medicine; 1648 McGrathiana Pkwy, Ste 550, Lexington, KY 40511; phone: 859-269-5626; or via email.


    National Academy of Medicine Launches First-Of-Its-Kind Comprehensive Resource Repository on Clinician Burnout and Well-Being

    Thursday, March 22, 2018  The National Academy of Medicine (NAM) today launched the Clinician Well-Being Knowledge Hub, a comprehensive resource repository that provides clinicians and health system leaders with valuable resources to combat clinician burnout in their organizations and personal lives. The knowledge hub is part of the Action Collaborative on Clinician Well-Being and Resilience, of which the American Board of Family Medicine is a participating organization.

    More than half of U.S. physicians currently experience burnout, a syndrome characterized by a high degree of emotional exhaustion, depersonalization, and a low sense of personal accomplishment at work. Nurses, dentists, pharmacists, and other health care professionals are also experiencing alarming rates of burnout, putting an unsustainable strain on the health care system.

    Improving clinician well-being requires sustained attention and action at the local, state, and national levels. The Clinician Well-Being Knowledge Hub provides a comprehensive overview of the causes of clinician burnout; its consequences for health care professionals, patients, and their families; and innovative approaches that organizations can take to promote clinician well-being. This easy-to-navigate resource center includes research articles, news articles, blog posts, toolkits, reports, and briefs on clinician burnout and well-being. The knowledge hub provides a central source for health system leaders, clinicians, and trainees, to not only better understand what’s causing burnout, but to adopt solutions that promise a brighter, healthier future.

    “While challenges to promote clinician well-being are numerous, progress is possible. The NAM is proud to launch the Clinician Well-Being Knowledge Hub,” said National Academy of Medicine President Victor J. Dzau. “Our hope is that the knowledge hub will not only elevate promising solutions, but will encourage leaders to critically think about how burnout affects their organizations and to implement the solutions that are right for them.”

    To explore the knowledge hub, please visit Clinician Well Being.


    Gap Between Preparation and Practice Among Early Career Family Physicians

    Wednesday, March 14, 2018  A recent study from researchers at the American Board of Family Medicine (ABFM) and the Robert Graham Center in Washington, DC indicates early career family physicians reported much higher preparation to practice all clinical activities and procedures queried than what they reported providing.

    The data were gathered from the 2016 National Graduate Survey of ABFM Diplomates who completed residency in 2013 and included a series of paired dichotomous questions asking whether the respondent was prepared to practice and was practicing 25 specific services. The largest gaps between preparation and practice were for neonatal circumcision, maternity care, and pediatric hospital care.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to:

    Lars E. Peterson, MD, PhD, American Board of Family Medicine; 1648 McGrathiana Pkwy, Ste 550, Lexington, KY 40511; phone: 859-269-5626


    Broader Scope of Practice Among Rural Family Physicians vs Urban Family Physicians

    Thursday, March 1, 2018  A recent study conducted by researchers from the American Board of Family Medicine (ABFM) indicates rural family physicians have a broader scope of practice than urban family physicians.

    Using data from 18,846 family physicians, the study examined variations in the provision of 21 clinical services and 18 procedural services across metropolitan, large rural, small rural, and frontier areas. The percentage of family physicians providing each type of clinical and procedural service rose with increasing rurality. Rural family physicians were more likely to provide obstetrical deliveries, newborn care, pediatric care, occupational medicine, palliative care, and mental health care than urban family physicians. They were also more likely to see patients in the hospital and nursing home and to conduct home visits.

    Despite prior research that the scope of practice of family physicians has been shrinking, the study found that rural family physicians are maintaining a broad scope of practice, which is likely necessary in rural areas where there are fewer options to access more specialized medical services.

    Click Here for the complete article.

    Correspondence and inquiries should be addressed to: Lars E. Peterson, MD, PhD, American Board of Family Medicine


    Scope of Practice Among Rural Family Physicians in Patient Centered Medical Homes

    Thursday, March 1, 2018  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.

    Click here for the complete article.

    Correspondence and inquiries should be addressed to: Lars E. Peterson, MD, PhD, American Board of Family Medicine


    Call for Applications for a Precepting Performance Improvement Program

    Monday, February 5, 2018  The American Board of Family Medicine (ABFM) and the Society of Teachers of Family Medicine (STFM) are now accepting applications from academic units to be sponsoring institutions in a Precepting Performance Improvement Pilot Program.

    This program offers Performance Improvement credit for certification (previously MOC Part IV) to ABFM diplomates who provide personal instruction, training, and supervision to a medical student or resident and who participate in a teaching improvement activity. ABFM is piloting the program before opening it up to all academic units/preceptors.

    To learn more Click Here.


    Burnout Among Young Family Medicine Physicians

    Monday, January 29, 2018   The American Board of Family Medicine obtained data from the inaugural National Graduate Survey in 2016 revealing symptoms of burnout from emotional exhaustion and callousness at 39.8% and 23.7%, respectively.

    Burnout refers to the psychological exhaustion resulting from long-term stress, and it puts physicians at risk for poor mental health, decreased productivity, and abandonment of career medicine. The data included two validated questions measuring emotional exhaustion and callousness. Only states with sample sizes of over 30 respondents were included. Variation among the states ranged from a rate of 55.4% emotional exhaustion in Minnesota to 16.1% in South Carolina. Colorado reported the highest rate of callousness or depersonalization at 35.3%, while South Carolina reported the lowest rate at 9.7%.

    Variation among states suggests that there may be state-level factors, such as policies, payer-mix, or even culture that affect burnout.

    The complete Article Burnout in Young Family Physicians: Variation Across States may be found here.

    Inquiries and correspondence should be addressed to Lars E. Peterson, MD, PhD, American Board of Family Medicine, 1648 McGrathiana Parkway, Suite 550, Lexington, KY 40511-1247


    Study Reveals Impressions on the American Board of Family Medicine's Continuing Certification Activities

    Monday, January 29, 2018  Using feedback collected from American Board of Family Medicine Diplomates, the authors analyzed quantitative and qualitative data from 320,500 surveys of family physicians who completed a Self-Assessment Module (SAM) between January 2004 and April 2013. Currently, to maintain board certification, physicians must meet standards that revolve around the American Board of Medical Specialties (ABMS) Program for maintenance of certification (MOC). To date, there has been little published evidence regarding the experience of American Board of Family Medicine (ABFM) diplomates with Maintenance of Certification for Family Physicians (MC-FP).

    The results from this study revealed overall positive experiences with SAM activities, with Knowledge Assessment (KA) components receiving higher satisfaction scores than the Clinical Simulation (CS) activities. Positive comments about SAM activities outnumbered negative comments two to one. However, while SAM activities were rated positively overall, there was great variability between individual modules. On average, SAMs with greater discordance between educational material addressed in the KA and CS components received lower ratings from Diplomates, CS components across all modules received negative comments regarding technical issues with the online testing platform.

    The complete article can be found here.

    Correspondence and inquiries should be addressed to E. Marshall Brooks, PhD, VCU Department of Family Medicine and Population Health, One Capital Square Building, 830 East Main Street, Rm 628, Richmond, VA 23219-0101