Family medicine: Difference between revisions
Content deleted Content added
m Reverting possible vandalism by Family Medicine to version by Fuzbaby. False positive? Report it. Thanks, ClueBot. (754771) (Bot) |
No edit summary |
||
| Line 1: | Line 1: | ||
{{Refimprove|date=May 2008}} |
{{Refimprove|date=May 2008}} |
||
| ⚫ | '''Family medicine''' doctors may hold one of the following [[medical school|medical degrees]], either (MD, MBBS, MBChB, etc) or (DO) degree. Physician who specialize in family medicine (also known as a family physician), however, must complete a three-year family medicine residency in addition to their medical degree, and are eligible for the [[board certification]] now required by most hospitals and health plans. |
||
{{globalize/USA|date=November 2008}} |
|||
| ⚫ | |||
Family medicine is the primary care medical specialty which "provides continuing, comprehensive health care for the individual and family... The scope of family medicine encompasses all ages, both sexes, each organ system, and every disease entity."<ref>[https://www.theabfm.org/about/policy.aspx "Definitions and Policies"], American Board of Family Medicine. Retrieved 6-30-2009.</ref> |
|||
| ⚫ | Most family physicians practice in solo or small-group private practices or as hospital employees in practices of similar sizes owned by hospitals. Still, many choose to teach medicine at medical schools or family medicine residency programs, though usually for much less pay. Others choose to practice as consultants to various medical institutions, including insurance companies. |
||
Family Medicine is not limited by age, sex, organ system or type of problem, be it biological, behavioral or social. A family physician’s care is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion. <ref>[http://www.aafp.org/online/en/home/aboutus/specialty/definitions.html "Definitions, What is Family Medicine?"], American Academy of Family Physicians. Retrieved 7-17-09.</ref> |
|||
| ⚫ | '''Family medicine''' doctors |
||
| ⚫ | The term "family medicine" is used in many European countries instead of "general medicine" or " |
||
Family physicians deliver a range of acute, chronic and preventive medical care services. In addition to diagnosing and treating illness, they also provide preventive care, including routine checkups, health-risk assessments, immunization and screening tests, and personalized counseling on maintaining a healthy lifestyle. Family physicians also manage chronic illness, often coordinating care provided by other subspecialists. <ref>[http://www.aafp.org/online/en/home/policy/policies/f/scopephil.html "Family Medicine, Scope and Philosophical Statement"], American Academy of Family Physicians. Retrieved 7-17-09.</ref> |
|||
Nearly one in four of all office visits are made to family physicians. That is 208 million office visits each year — nearly 83 million more than the next largest medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. <ref> [http://www.aafp.org/online/en/home/aboutus/specialty/facts.html "Facts About Family Medicine"], ''American Academy of Family Physicians''. Retrieved 7-17-09.</ref> |
|||
| ⚫ | Most family physicians practice in solo or small-group private practices or as hospital employees in practices of similar sizes owned by hospitals. |
||
Today, family physicians provide the majority of care for America's underserved rural and urban populations. In fact, more than a third of all U.S. counties, with a combined population exceeding 40 million Americans, depend on family physicians to avoid designation as primary care health profession shortage areas. <ref> [http://www.aafp.org/online/en/home/aboutus/specialty/facts.html "Facts About Family Medicine"], ''American Academy of Family Physicians''. Retrieved 7-17-09.</ref> |
|||
== Family medicine in USA == |
== Family medicine in USA == |
||
Starting in the 1970s, many family physicians in the United States began to consider the terms "general practitioner" and "GP" as somewhat demeaning and derogatory, discounting their additional years of training. It was not until 1969 that family medicine (formerly known as family practice) was recognized as a distinct specialty in the U.S.<ref>{{cite web|url=https://www.theabfm.org/about/history.aspx|title=History of the Specialty|publisher=[[American Board of Family Medicine]]|author= Pisacano, Nicholas J.|accessdate=2007-08-08}}</ref> |
|||
A family physician is board-certified in family medicine. Training is focused on treating an individual throughout all of his or her life stages. Family physicians will see anyone with any problem, but are experts in common problems. Many family physicians deliver babies in addition to taking care of patients of all ages. Family physicians complete undergraduate school, [[medical school]], and three more years of specialized [[medical residency]] training in family medicine. In order to remain board certified, family physicians take a written examination every six, seven, nine or 10 years, depending on what track they choose regarding the maintenance of their certification. Three hundred hours of continuing medical education within the prior six years is also required to be eligible to sit for the exam. |
|||
Family physicians complete undergraduate school, [[medical school]], and three more years of specialized [[medical residency]] training in family medicine. <ref>Adams, Bob. Primary Care. ''CQ Researcher'', 5 (10), March 17, 1995. </ref> Their residency training includes rotations in internal medicine, pediatrics, obstetrics-gynecology, psychiatry, and geriatrics. <ref>[https://www.theabfm.org/about/abfmbrochure.aspx "Patient Brochure"], American Board of Family Medicine. Retrieved 6-30-09. </ref> The specialty focuses on treating the whole person--acknowledging the effects of all outside influences-- through all life stages. <ref> [http://www.annfammed.org/cgi/reprint/2/suppl_1/s3 "The Future of Family Medicine: A Collaborative Project of the Family Medicine Community"](Mar-Apr, 2004), ''Annals of Family Medicine''. Retrieved 6-30-09. </ref> Family physicians will see anyone with any problem, but are experts in common problems. Many family physicians deliver babies in addition to taking care of patients of all ages. |
|||
Between 2003 and 2009 the board certification process is being changed in family medicine and all other [[American Board of Medical Specialties|American Specialty Boards]] to a series of yearly tests on differing areas within the given specialty. The [[American Board of Family Medicine]], as well as other specialty boards, are requiring additional participation in continuous learning and self-assessment to enhance clinical knowledge, expertise and skills. The Board has created a program called the "Maintenance of Certification Program for Family Physicians" (MC-FP) which will require family physicians to continuously demonstrate proficiency in four areas of clinical practice: professionalism, self assessment/lifelong learning, cognitive expertise, and performance in practice. |
|||
[[Certificate of added qualifications|Certificates of Added Qualifications]] (CAQs) in [[adolescence|adolescent]] medicine, [[geriatrics|geriatric medicine]], [[sports medicine]], [[sleep medicine]], and hospice and palliative medicine are available for those board-certified family physicians who meet additional training and testing requirements. Additionally, [[fellowship (medicine)|fellowships]] are available for family physicians in adolescent medicine, geriatrics, sports medicine, rural medicine, faculty development, [[hospitalist]], obstetrics, research, and preventative medicine. |
|||
The family medicine (FM) paradigm is bolstered by primary care physicians trained in [[internal medicine]] (IM); although these physicians are trained in internal medicine only, adult patients provide the majority of the patient base of many family medicine practices. |
The family medicine (FM) paradigm is bolstered by primary care physicians trained in [[internal medicine]] (IM); although these physicians are trained in internal medicine only, adult patients provide the majority of the patient base of many family medicine practices. In the United States, there is a rising contingent of physicians dually trained in internal medicine and pediatrics, which can be completed in four years, instead of the three years each for IM and pediatrics. A significant number of family medicine practices (especially in suburban and urban areas) do not provide obstetric services anymore (due to litigation issues and provider preference), and as such, this blurs the line between the FM and IM/Peds difference. One suggested difference is that the IM/Peds-trained physicians are more geared towards subspecialty training or hospital-based practice. Even so, there are groups with FM-trained and IM/Peds-trained physicians working in seamless harmony. |
||
There is currently a shortage of family physicians (and also other primary care providers) due to several factors, notably the lesser prestige associated with the young specialty, the lesser pay, and the increasingly frustrating practice environment in the U.S. Physicians are increasingly forced to do more administrative work, and to shoulder higher malpractice premiums due to insurance monopolies that charge excessive premiums, thus forcing doctors to spend less and less time with patient care due to the current payor model stressing patient volume vs. quality of care. |
|||
While many sources cite a shortage of family physicians (and also other primary care providers, i.e. internists, pediatricians, and general practitioners)<ref> Halsey, A. (2009, June 20). Primary-Care Doctor Shortage May Undermine Reform Efforts [Electronic version]. ''The Washington Post.'' Retrieved 6-30-09 from http://www.washingtonpost.com</ref>, the per capita supply of primary care physicians has actually increased about 1 percent per year since 1998.<ref> U.S. General Accounting Office. (2008). Primary care professionals (electronic resource): recent supply trends, projection, and valuation of services. Testimony before the Committee on Health, Education, Labor, and Pensions, U.S. Senate. Retrieved 6-30-09 from http://www.gao.gov/new.items/d08472t.pdf</ref> Additionally, a recent decrease in the number of M.D. graduates pursuing a residency in primary care, has been offset by the number of D.O graduates and graduates of international medical schools (IMGs) who enter primary care residencies.<ref> U.S. General Accounting Office. (2008). Primary care professionals (electronic resource): recent supply trends, projection, and valuation of services. Testimony before the Committee on Health, Education, Labor, and Pensions, U.S. Senate. Retrieved 6-30-09 from http://www.gao.gov/new.items/d08472t.pdf</ref> Still, projections indicate that by 2020 the demand for family physicians will exceed their supply. <ref> U.S. General Accounting Office. (2008). Primary care professionals (electronic resource): recent supply trends, projection, and valuation of services. Testimony before the Committee on Health, Education, Labor, and Pensions, U.S. Senate. Retrieved 6-30-09 from http://www.gao.gov/new.items/d08472t.pdf</ref> |
|||
The number of students entering family medicine residency training has fallen from a high of 3,293 in 1998 to 1,172 in 2008, according to National Residency Matching Program data. Fifty-five family medicine residency programs have closed since 2000, while only 28 programs have opened. <ref> [http://www.aafp.org/online/en/home/residents/match/summary.html "2009 Match Summary and Analysis"], ''American Academy of Family Physicians''. Retrieved 7-17-09.</ref> |
|||
In 2006, when the nation had 100,431 family physicians, a workforce report by the American Academy of Family Physicians indicated the United States would need 139,531 family physicians by 2020 to meet the need for primary medical care. To reach that figure 4,439 family physicians must complete their residencies each year, but currently the nation is attracting only half the number of future family physicians that we will need. <ref> [http://www.aafp.org/online/en/home/policy/policies/w/workforce.html "Family Physician Workforce Reform"], ''American Academy of Family Physicians''. Retrieved 7-17-09.</ref> |
|||
The waning interest in family medicine is likely due to several factors, including the lesser prestige associated with the specialty, the lesser pay, and the increasingly frustrating practice environment in the U.S. Salaries for family physicians in the United States are respectable but lower than average for physicians, with the average being $129,295 <ref name = "Payscale"> http://www.payscale.com/research/US/Industry=Family_Medicine/Salary</ref> and ranging from $110,000 to $204,000<ref>[http://www.modernhealthcare.com/article/20080714/REG/603020961 "2008 Physician compensation survey"], ''Modern Healthcare''. July 14, 2008. Retrieved 6-30-09.</ref>, but when faced with debt from medical school, most medical students are opting for the higher paying specialties. Family physicians are trained to manage acute and chronic health issues for an individual simultaneously, yet their appointment slots may average only ten minutes.<ref>Stange, K., Zyzanski, S. Jaen, C., Callahan, E., Kelly, R., Gillanders, W. et al. (1998). Illuminating the 'black box.' ''Journal of Family Practice'', 46 (5), p. 377-389.</ref> Physicians are increasingly forced to do more administrative work, and to shoulder higher malpractice premiums, thus forcing doctors to spend less and less time with patient care due to the current payor model stressing patient volume vs. quality of care. {{Citation needed|date=July 2009}} Things are starting to change as more insurance carriers consolidate. {{Citation needed|date=July 2009}} They are not stressing performance but more and more volume, thus increasing insurance company profit margins. {{Citation needed|date=July 2009}} Physicians are starting to shun insurance carriers to lessen the paperwork in order to focus more on patient care as they are originally trained to do. {{Citation needed|date=July 2009}} |
|||
There is a current trend among family physicians to adopt a practice model called the micro practice, or "[[Ideal Medical Practice]]". {{Citation needed|date=July 2009}} These practices focus on reducing their [[overhead]] and increase their utilization of technology. {{Citation needed|date=July 2009}} Because the overhead is reduced, the need to see a high volume of patients to generate more revenue is diminished. This allows the doctor to spend more time with their patients, which results in higher satisfaction for the patient and the physician. {{Citation needed|date=July 2009}} |
|||
==Family Medicine in Canada== |
|||
Traditionally, family medical doctors perform specialized work in matters pertaining to reproduction or reproductive disorders. Doctors practicing outside of hospitals with clients are referred to as [[General Practitioners]] or GPs. |
|||
Doctors working in family medicine typically work in hospital departments. Working within an acute care setting the doctors work collaboratively as interdisciplinary teams associated with a number of services and programs to address patient care and clinical practice issues. |
|||
The clinical role of the doctor is to provide a full range of primary care services, including obstetrical care and newborn care, and provide inpatient palliative care and consultation. More specifically, the doctor provides comprehensive continuous care, disease prevention, and health promotion services including both general assessment and provision of preventive care and health promotion, diagnoses and treats acute and chronic health problems with appropriate specialty assistance, provides full reproductive and new born care, provides mental health care and appropriate supportive counseling, provides child health care, provides supportive in-hospital care, and, finally, continues to provide services for patients following their release from the hospital. |
|||
The doctor contributes to the discipline of family medicine by conducting appropriate, funded research and evaluation projects. |
|||
==References== |
==References== |
||
| Line 56: | Line 26: | ||
[[Category:Family medicine| ]] |
[[Category:Family medicine| ]] |
||
[[id:Dokter keluarga]] |
|||
[[ko:가정의학]] |
|||
[[ja:家庭医療]] |
|||
Revision as of 06:18, 14 August 2009
 | This article needs additional citations for verification. (May 2008) |
Family medicine doctors may hold one of the following medical degrees, either (MD, MBBS, MBChB, etc) or (DO) degree. Physician who specialize in family medicine (also known as a family physician), however, must complete a three-year family medicine residency in addition to their medical degree, and are eligible for the board certification now required by most hospitals and health plans.
The term "family medicine" is used in many European countries instead of "general medicine" or "general practice". In Sweden, certification in family medicine needs five years working with tutor, after the medical degree. Similar systems have been implemented in other countries.
Most family physicians practice in solo or small-group private practices or as hospital employees in practices of similar sizes owned by hospitals. Still, many choose to teach medicine at medical schools or family medicine residency programs, though usually for much less pay. Others choose to practice as consultants to various medical institutions, including insurance companies.
Family medicine in USA
Starting in the 1970s, many family physicians in the United States began to consider the terms "general practitioner" and "GP" as somewhat demeaning and derogatory, discounting their additional years of training. It was not until 1969 that family medicine (formerly known as family practice) was recognized as a distinct specialty in the U.S.[1]
A family physician is board-certified in family medicine. Training is focused on treating an individual throughout all of his or her life stages. Family physicians will see anyone with any problem, but are experts in common problems. Many family physicians deliver babies in addition to taking care of patients of all ages. Family physicians complete undergraduate school, medical school, and three more years of specialized medical residency training in family medicine. In order to remain board certified, family physicians take a written examination every six, seven, nine or 10 years, depending on what track they choose regarding the maintenance of their certification. Three hundred hours of continuing medical education within the prior six years is also required to be eligible to sit for the exam.
Between 2003 and 2009 the board certification process is being changed in family medicine and all other American Specialty Boards to a series of yearly tests on differing areas within the given specialty. The American Board of Family Medicine, as well as other specialty boards, are requiring additional participation in continuous learning and self-assessment to enhance clinical knowledge, expertise and skills. The Board has created a program called the "Maintenance of Certification Program for Family Physicians" (MC-FP) which will require family physicians to continuously demonstrate proficiency in four areas of clinical practice: professionalism, self assessment/lifelong learning, cognitive expertise, and performance in practice.
Certificates of Added Qualifications (CAQs) in adolescent medicine, geriatric medicine, sports medicine, sleep medicine, and hospice and palliative medicine are available for those board-certified family physicians who meet additional training and testing requirements. Additionally, fellowships are available for family physicians in adolescent medicine, geriatrics, sports medicine, rural medicine, faculty development, hospitalist, obstetrics, research, and preventative medicine.
The family medicine (FM) paradigm is bolstered by primary care physicians trained in internal medicine (IM); although these physicians are trained in internal medicine only, adult patients provide the majority of the patient base of many family medicine practices. In the United States, there is a rising contingent of physicians dually trained in internal medicine and pediatrics, which can be completed in four years, instead of the three years each for IM and pediatrics. A significant number of family medicine practices (especially in suburban and urban areas) do not provide obstetric services anymore (due to litigation issues and provider preference), and as such, this blurs the line between the FM and IM/Peds difference. One suggested difference is that the IM/Peds-trained physicians are more geared towards subspecialty training or hospital-based practice. Even so, there are groups with FM-trained and IM/Peds-trained physicians working in seamless harmony.
There is currently a shortage of family physicians (and also other primary care providers) due to several factors, notably the lesser prestige associated with the young specialty, the lesser pay, and the increasingly frustrating practice environment in the U.S. Physicians are increasingly forced to do more administrative work, and to shoulder higher malpractice premiums due to insurance monopolies that charge excessive premiums, thus forcing doctors to spend less and less time with patient care due to the current payor model stressing patient volume vs. quality of care.
References
- ^ Pisacano, Nicholas J. "History of the Specialty". American Board of Family Medicine. Retrieved 2007-08-08.
