Phoenix Newsletter - October 2025 President’s Message: Enduring Commitments in a Time of Change Read President’s Message: Enduring Commitments in a Time of Change
Home Research Research Library The Declining Scope of Practice of Family Physicians Is Limited to Urban Areas The Declining Scope of Practice of Family Physicians Is Limited to Urban Areas 2021 Author(s) Nasim, Urooj, Morgan, Zachary J, and Peterson, Lars E Topic(s) What Family Physicians Do Keyword(s) Visiting Scholar/Fellow Volume Journal of Rural Health Source Journal of Rural Health PURPOSE: Scope of practice of family physicians (FPs) has been decreasing overall. Our objective was to determine if the distribution of declining scope occurs across urban and rural settings. METHODS: We used secondary data from practicing FPs collected on the American Board of Family Medicine examination registration demographic questionnaire from 2014 to 2016 on scope of practice merged with county-level data from the Area Health Resources File. Rurality was assigned using 4 population-based groupings from the Rural Urban Continuum Codes. Outcome measures were scope of practice score (0-30, higher score reflecting broader scope) and provision of specific types of care/procedures. Bivariate statistics assessed changes in scope of practice over time. Adjusted regression models tested associations between time, physician, practice, and county characteristics with scope of practice score. FINDINGS: Our sample was 27,343 practicing FPs. Overall, the scope score decreased from 15.5 to 15.0 (P value < .05) but was significant only for urban settings. Regression analysis found that scope decreased each year (β = -0.15), broader scope for rural FPs, and no interaction between year and rural. CONCLUSIONS: The decrease in FP scope of practice is largely an urban phenomenon. FPs in rural areas have a broad scope of practice, which may ensure access to care in rural areas that rely on FPs to provide a large portion of health care services. However, county characteristics like persistent poverty and the presence of nurse practitioners, physician assistants, and other physicians were associated with changes in scope that may modify the gains associated with rurality. ABFM Research Read all 2013 Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care Go to Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care 2021 A Cross-Sectional Study of Factors Associated With Pediatric Scope of Care in Family Medicine Go to A Cross-Sectional Study of Factors Associated With Pediatric Scope of Care in Family Medicine 2023 Rural Versus Urban Family Medicine Residency Scope of Training and Practice Go to Rural Versus Urban Family Medicine Residency Scope of Training and Practice 1992 1991 certification-recertification examinations Go to 1991 certification-recertification examinations
Author(s) Nasim, Urooj, Morgan, Zachary J, and Peterson, Lars E Topic(s) What Family Physicians Do Keyword(s) Visiting Scholar/Fellow Volume Journal of Rural Health Source Journal of Rural Health
ABFM Research Read all 2013 Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care Go to Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care 2021 A Cross-Sectional Study of Factors Associated With Pediatric Scope of Care in Family Medicine Go to A Cross-Sectional Study of Factors Associated With Pediatric Scope of Care in Family Medicine 2023 Rural Versus Urban Family Medicine Residency Scope of Training and Practice Go to Rural Versus Urban Family Medicine Residency Scope of Training and Practice 1992 1991 certification-recertification examinations Go to 1991 certification-recertification examinations
2013 Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care Go to Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care
2021 A Cross-Sectional Study of Factors Associated With Pediatric Scope of Care in Family Medicine Go to A Cross-Sectional Study of Factors Associated With Pediatric Scope of Care in Family Medicine
2023 Rural Versus Urban Family Medicine Residency Scope of Training and Practice Go to Rural Versus Urban Family Medicine Residency Scope of Training and Practice
1992 1991 certification-recertification examinations Go to 1991 certification-recertification examinations