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Home Research Research Library Comparison of Intended Scope of Practice for Family Medicine Residents With Reported Scope of Practice Among Practicing Family Physicians Comparison of Intended Scope of Practice for Family Medicine Residents With Reported Scope of Practice Among Practicing Family Physicians 2015 Author(s) Coutinho, Anastasia J, Cochrane, Anneli, Stelter, Keith L, Phillips, Robert L, and Peterson, Lars E Topic(s) What Family Physicians Do Keyword(s) Continuing Certification Questionnaires, Maternity Care, Children & Adolescents, Mental Health Care, Graduating Resident Questionnaire, and Geriatric Care Volume 314(22):2364-2372 Source JAMA IMPORTANCE: Narrowing of the scope of practice of US family physicians has been well documented. Proposed reasons include changing practice patterns as physicians age, employer restrictions, or generational choices. Determining components of care that remain integral to the practice of family medicine may be informed by assessing gaps between the intended scope of practice of residents and actual scope of practice of family physicians. OBJECTIVE: To compare intended scope of practice for American Board of Family Medicine (ABFM) initial certifiers at residency completion with self-reported actual scope of practice of recertifying family physicians. DESIGN AND PARTICIPANTS: Cross-sectional data were collected from a practice demographic questionnaire completed by all individuals applying to take the ABFM Maintenance of Certification for Family Physicians examination. Initial certifiers reported intentions and recertifiers reported actual provision of specific clinical activities. All physicians who registered for the 2014 ABFM Maintenance of Certification for Family Physicians examination were included: 3038 initial certifiers and 10,846 recertifiers. EXPOSURES: Initially certifying physicians vs recertifying physicians. MAIN OUTCOMES AND MEASURES: The Scope of Practice for Primary Care score (scope score), a psychometric scale, was calculated for each physician and ranged from 0 to 30, with higher numbers equating to broader scope of practice. Recertifiers were categorized by decades in practice. RESULTS: The final sample included 13,884 family physicians and, because the questionnaire was a required component of the examination application, there was a 100% response rate. Mean scope score was significantly higher for initial certifier intended practice compared with recertifying physicians’ reported actual practices (17.7 vs 15.5; difference, 2.2 [95% CI, 2.1-2.3]; P < .001). Compared with recertifiers, initial certifiers were more likely to report intending to provide all clinical services asked except pain management; this included obstetric care (23.7% vs 7.7%; difference, 16.0% [95% CI, 14.4%-17.6%]; P < .001), inpatient care (54.9% vs 33.5%; difference, 21.4% [95% CI, 19.4%-23.4%]; P < .001), and prenatal care (50.2% vs 9.9%; difference, 40.3 [95% CI, 38.5%-42.2%]; P < .001). Similar differences from initial certifiers were present when comparisons were limited to recertifiers in practice for only 1 to 10 years. CONCLUSIONS AND RELEVANCE: In this study of family physicians taking ABFM examinations, graduating family medicine residents reported an intention to provide a broader scope of practice than that reported by current practitioners. This pattern suggests that these differences are not generational, but whether they are due to limited practice support, employer constraints, or other causes remains to be determined. Read More ABFM Research Read all 2021 Distribution of Physician Specialties by Rurality Go to Distribution of Physician Specialties by Rurality 2021 How Comprehensive Medication Management Contributes to Foundational Elements of Primary Care Go to How Comprehensive Medication Management Contributes to Foundational Elements of Primary Care 2020 Taking a Closer Look at Mental Health Treatment Differences: Effectiveness of Mental Health Treatment by Provider Type in Racial and Ethnic Minorities Go to Taking a Closer Look at Mental Health Treatment Differences: Effectiveness of Mental Health Treatment by Provider Type in Racial and Ethnic Minorities 2020 Practice Predictors of Buprenorphine Prescribing by Family Physicians Go to Practice Predictors of Buprenorphine Prescribing by Family Physicians
Author(s) Coutinho, Anastasia J, Cochrane, Anneli, Stelter, Keith L, Phillips, Robert L, and Peterson, Lars E Topic(s) What Family Physicians Do Keyword(s) Continuing Certification Questionnaires, Maternity Care, Children & Adolescents, Mental Health Care, Graduating Resident Questionnaire, and Geriatric Care Volume 314(22):2364-2372 Source JAMA
ABFM Research Read all 2021 Distribution of Physician Specialties by Rurality Go to Distribution of Physician Specialties by Rurality 2021 How Comprehensive Medication Management Contributes to Foundational Elements of Primary Care Go to How Comprehensive Medication Management Contributes to Foundational Elements of Primary Care 2020 Taking a Closer Look at Mental Health Treatment Differences: Effectiveness of Mental Health Treatment by Provider Type in Racial and Ethnic Minorities Go to Taking a Closer Look at Mental Health Treatment Differences: Effectiveness of Mental Health Treatment by Provider Type in Racial and Ethnic Minorities 2020 Practice Predictors of Buprenorphine Prescribing by Family Physicians Go to Practice Predictors of Buprenorphine Prescribing by Family Physicians
2021 Distribution of Physician Specialties by Rurality Go to Distribution of Physician Specialties by Rurality
2021 How Comprehensive Medication Management Contributes to Foundational Elements of Primary Care Go to How Comprehensive Medication Management Contributes to Foundational Elements of Primary Care
2020 Taking a Closer Look at Mental Health Treatment Differences: Effectiveness of Mental Health Treatment by Provider Type in Racial and Ethnic Minorities Go to Taking a Closer Look at Mental Health Treatment Differences: Effectiveness of Mental Health Treatment by Provider Type in Racial and Ethnic Minorities
2020 Practice Predictors of Buprenorphine Prescribing by Family Physicians Go to Practice Predictors of Buprenorphine Prescribing by Family Physicians