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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. Read More ABFM Research Read all 2014 Trends in Family Physicians Performing Deliveries, 2003-2010 Go to Trends in Family Physicians Performing Deliveries, 2003-2010 2018 Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice Go to Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice 2018 Frequency and Criticality of Diagnoses in Family Medicine Practices: From the National Ambulatory Medical Care Survey (NAMCS) Go to Frequency and Criticality of Diagnoses in Family Medicine Practices: From the National Ambulatory Medical Care Survey (NAMCS) 2025 The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project Go to The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project
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 2014 Trends in Family Physicians Performing Deliveries, 2003-2010 Go to Trends in Family Physicians Performing Deliveries, 2003-2010 2018 Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice Go to Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice 2018 Frequency and Criticality of Diagnoses in Family Medicine Practices: From the National Ambulatory Medical Care Survey (NAMCS) Go to Frequency and Criticality of Diagnoses in Family Medicine Practices: From the National Ambulatory Medical Care Survey (NAMCS) 2025 The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project Go to The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project
2014 Trends in Family Physicians Performing Deliveries, 2003-2010 Go to Trends in Family Physicians Performing Deliveries, 2003-2010
2018 Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice Go to Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice
2018 Frequency and Criticality of Diagnoses in Family Medicine Practices: From the National Ambulatory Medical Care Survey (NAMCS) Go to Frequency and Criticality of Diagnoses in Family Medicine Practices: From the National Ambulatory Medical Care Survey (NAMCS)
2025 The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project Go to The Association Between Residency Characteristics and Graduates Caring for Children: A Family Medicine Residency Outcomes Project