Data Watch: Family Physicians More Likely to Practice in Rural Areas

2012 ◽  
Vol 42 (9) ◽  
pp. 5
Keyword(s):  
Rural Areas ◽  
Family Physicians

scholarly journals Geographical distribution of family physicians in Japan: A nationwide cross-sectional study

2019 ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results 519 JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p<0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

Current Distribution and Trends in the Location Pattern of Pediatricians, Family Physicians, and General Practitioners Between 1976 and 1979

PEDIATRICS ◽  
1982 ◽  
Vol 70 (5) ◽  
pp. 780-789 ◽  
Author(s):  
Peter P. Budetti ◽  
Phillip R. Kletke ◽  
John P. Connelly
Keyword(s):  
United States ◽  
Child Health ◽  
General Practitioners ◽  
Current Distribution ◽  
Rural Areas ◽  
Family Physicians ◽  
The United States ◽  
Location Pattern ◽  
Small Communities ◽  
Urban Concentration

The literature suggests that pediatricians in the United States are concentrated in the more densely populated regions and states, whereas family physicians and general practitioners are more likely to settle in rural areas. The rapidly increasing supply of all child health physicians had led many to hypothesize that the traditional geographic preferences of pediatricians would expand to include smaller communities. Data for 1976 to 1979 confirm the urban concentration of pediatricians and the more even distribution of family physicians and general practitioners. These data also demonstrate a marked imbalance of pediatricians within county groups, resulting in some areas of shortage even within highly metropolitan communities. Evidence of a trend toward increased dispersion of pediatricians into urban shortage areas is presented, but there is no indication that enough pediatricians will settle in rural areas to meet the needs of children in those small communities.

scholarly journals Neonatal Resuscitation Skills Among Pediatricians and Family Physicians: Is Residency Training Preparing for Postresidency Practice?

2011 ◽  
Vol 3 (4) ◽  
pp. 475-480 ◽  
Author(s):  
Amy M. Wood ◽  
M. Douglas Jones ◽  
James H. Wood ◽  
Zhaoxing Pan ◽  
Thomas A. Parker
Keyword(s):  
Family Medicine ◽  
Rural Areas ◽  
Current Practice ◽  
Neonatal Resuscitation ◽  
Family Physicians ◽  
Newborn Resuscitation ◽  
Rural Physicians ◽  
Resuscitation Training ◽  
National Cohort ◽  
Umbilical Catheters

Abstract Background Pediatricians and family physicians are responsible for providing newborn resuscitation, yet Accreditation Council for Graduate Medical Education requirements for training in this area during residency differ markedly for the two specialties. Our objectives were to determine (1) the extent to which neonatal resuscitation training differs for pediatric and family medicine residents; (2) the extent to which general pediatricians and family physicians engage in newborn resuscitation in their practice; and (3) whether use of resuscitation skills differs between urban/suburban and rural providers. Methods We surveyed a national cohort of pediatricians and family physicians who obtained board certification between 2001 and 2005. Data were analyzed based on type of physician and setting of current practice. Results Survey response rate was 22% (382 of 1736). Compared with family medicine physicians, pediatricians received more neonatal resuscitation training during residency. Most members of both groups had attended no deliveries in the year prior to the survey (75% [111 of 148] versus 74% [114 of 154]). In their current practice, the groups were equally likely to have provided a newborn bag and mask ventilation, chest compressions, and resuscitation medications. Pediatricians were more likely than family physicians to have attempted to either intubate a newborn (20% [28 of 148] versus 10% [16 of 153]; P  =  .0495) or insert umbilical catheters (15% [22 of 148] versus 5% [8 of 153]; P  =  .005). Regardless of specialty, rural physicians were much more likely to report that they attended deliveries (61% [41 of 67] versus 15% [36 of 234]; P &lt; .001). Among rural pediatricians attending deliveries, 44% (7 of 16) reported feeling inadequately prepared for at least one delivery in the past year. Conclusions Few primary care pediatricians and family physicians provide newborn resuscitation after residency. For those who do attend deliveries, current training may provide insufficient preparation. Flexible, individualized residency curricula could target intensive resuscitation training to individuals who plan to practice in rural areas and/or attend deliveries after graduation.

scholarly journals Effect of a brief emergency medicine education course on emergency department work intensity of family physicians

CJEM ◽  
2013 ◽  
Vol 15 (01) ◽  
pp. 34-41
Author(s):  
Samuel Vaillancourt ◽  
Susan E. Schultz ◽  
Chad Leaver ◽  
Thérèse Stukel ◽  
Michael J. Schull
Keyword(s):  
Emergency Medicine ◽  
Rural Areas ◽  
Urban Areas ◽  
Cohort Analysis ◽  
Family Physicians ◽  
High Volume ◽  
Work Intensity ◽  
Term Care ◽  
Physician Staffing ◽  
Before And After

ABSTRACT Background: Recently, many Canadian emergency departments (EDs) have struggled with physician staffing shortages. In 2006, the Ontario Ministry of Health and Long-Term Care funded a brief “emergency medicine primer” (EMP) course for family physicians to upgrade or refresh skills, with the goal of increasing their ED work intensity. We sought to determine the effect of the EMP on the ED work intensity of family physicians. Methods: A retrospective longitudinal study was conducted of the ED work of 239 family physicians in the 2 years before and after a minimum of 6 months and up to 2 years from completing an EMP course in 2006 to 2008 compared to non-EMP physicians. ED work intensity was defined as the number of ED shifts per month and the number of ED patients seen per month. We conducted two analyses: a before and after comparison of all EMP physicians and a matched cohort analysis matching each EMP physician to four non-EMP physicians on sex, year of medical school graduation, rurality, and pre-EMP ED work intensity. Results: Postcourse, EMP physicians worked 0.5 more ED shifts per month (13% increase, p = 0.027). Compared to their matched controls, EMP physicians worked 0.7 more shifts per month (13% increase, p = 0.0032) and saw 15 more patients per month (17% increase, p = 0.0008) compared to matched non-EMP physicians. The greatest increases were among EMP physicians who were younger, were urban, had previous ED experience, or worked in a high-volume ED. The effect of the EMP course was negligible for physicians with no previous ED experience or working in rural areas. Conclusion: The EMP course is associated with modest increases in ED work intensity among some family physicians, in particular younger physicians in urban areas. No increase was seen among physicians without previous ED experience or working in rural areas.

scholarly journals Curative Care Utilization under Family Medicine and Rural Insurance in Amol – Iran

2018 ◽  
Author(s):  
Samad Rouhani ◽  
Sayed Hamid Daryabary
Keyword(s):  
Rural Areas ◽  
Family Physicians ◽  
Healthcare Systems ◽  
Care Utilization ◽  
Severity Of Disease ◽  
Curative Care ◽  
Crucial Information ◽  
Spss Software ◽  
The Government ◽  
Local Family

Background and purpose: Reliable information about utilization of medical services is key for making appropriate decisions of all healthcare systems. Nonetheless, most policy decisions and planning in the rural areas of developing countries are made with the lack of such crucial information. In this article we attempt to reveal the pattern of curative care utilization of rural population in Amol, a county in Northern Province of Mazandaran. Methods: In this study 355 patients living in rural area who in the last three month utilized curative care from different providers were interviewed in their doorsteps. All interviewees were heads of family or people age above 15. SPSS software was used for analyzing the data. Results: About a quarter of patients (24.5%) have referred to their local family physicians. It is noticeable that the proportion of people who referred to GP out of family physicians scheme exceeds the proportion of patients referred to GPs who are working as family physicians in the FMRI scheme. Among the studied variables, only basic insurance, severity of disease, and type of care utilized had significant association with referred or not referred of individuals to their own family physicians.Conclusion:Family medicine and rural insurance in Iran has increased the overall service utilization of population in rural areas but not in the scale that the government has spent its limited healthcare resources. This raises the concern of inappropriate resource allocation for inappropriate people and inappropriate services. 

scholarly journals Geographical distribution of family physicians in Japan: a nationwide cross-sectional study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results Five hundred nineteen JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p < 0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

scholarly journals Current status of family medicine in Kenya; family physicians’ perception of their role

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Kaja Momanyi ◽  
Geert-Jan Dinant ◽  
Marlieke Bouwmans ◽  
Simone Jaarsma ◽  
Patrick Chege
Keyword(s):  
Family Medicine ◽  
Rural Areas ◽  
Family Physicians ◽  
Current Status ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Online Questionnaire ◽  
Questionnaire Response ◽  
Suitable Definition ◽  
Definition Of

Background: Family medicine (FM) was introduced in Kenya in 2005. Up to date (August 2019), 42 family physicians have graduated from Kenyan Universities.Aim: The aim of the study was to establish the current state of FM in Kenya and identify areas for more research and actions to support and improve FM in Kenya.Setting: Interviews were conducted at the different work sites of the participants, four of them in hospitals, one at a University and one in a hotel where a FM conference was held.Methods: An online questionnaire (response rate = 56%) and six semi-structured interviews were conducted amongst family physicians who completed their studies in Kenya. However, the focus was on the interviews.Results: Family physicians have different ideas of how FM should look like ideally, but all agree that family physicians should be team leaders of a primary healthcare team, taking care of a defined population. Lack of policies, low numbers of family physicians and the misunderstanding of FM by all stakeholders are the major challenges. Sixty-four percent of the participants work in rural areas, and 77% perceive their current work as FM.Conclusion: Family medicine must be defined and properly promoted. Various areas have been identified that require further research: assessing required number of family physicians, reasons and solutions for the low number of family physicians, funding possibilities, and research the most suitable definition of a Kenyan family physician.

Training to reduce behavioral health disparities

2017 ◽  
Vol 52 (3) ◽  
pp. 298-312 ◽  
Author(s):  
Jennifer S Robohm
Keyword(s):  
Health Disparities ◽  
Behavioral Health ◽  
Rural Areas ◽  
Behavioral Science ◽  
Emotional Health ◽  
Family Physicians ◽  
Health Behavior Change ◽  
Mental Health Stigma ◽  
Behavioral Skills ◽  
Science Training

Family physicians are a critical part of the healthcare system in rural areas, but little is known about the training they need to more effectively address behavioral health disparities. Practicing family physicians in Montana were surveyed about the behavioral health needs of their patients, the behavioral resources at their disposal, their prioritization of a number of behavioral skills and interventions in the training of family physicians, factors that limit their own use of behavioral skills, and the extent of their behavioral science training. Respondents across the state reported high rates of mental/emotional health issues and high need for health behavior change in their patients. Surprisingly, although rural family physicians reported access to significantly fewer behavioral health resources, they did not rate any of the behavioral skills as higher training priorities than their urban counterparts and they were more likely to identify limitations (lack of patient interest, lack of confidence or competence, and inadequate knowledge or training) on their own use of such skills in practice. Family physicians, both rural and urban, whose residency programs had a higher emphasis on behavioral science felt better prepared to use behavioral skills in practice. Consequently, rural training programs are encouraged to emphasize behavioral science training for their family medicine residents, particularly training that focuses on mental health stigma reduction, emphasizes time savings and practicality, covers more severe psychiatric presentations, promotes cultural sensitivity to rural values of autonomy and self-sufficiency, and teaches skills to advocate for individual and community health with regard to behavioral health disparities.

scholarly journals Family Medicine and Emergency Redeployment: Unrealized Potential

2022 ◽  
Vol 54 (1) ◽  
pp. 44-46
Author(s):  
Hoon Byun ◽  
John M. Westfall
Keyword(s):  
Family Medicine ◽  
Residency Training ◽  
Rural Areas ◽  
Family Physicians ◽  
Physician Assistants ◽  
Scope Of Practice ◽  
Separate Analysis ◽  
Medicare Beneficiaries ◽  
Emergency Rooms ◽  
Training Requirements

Background and Objectives: Discussions of scope of practice among family physicians has become a crucial topic amidst the COVID-19 pandemic, coupled with new attention to residency training requirements. Family medicine has seen a gradual narrowing of practice due to a host of issues, including physician choice, expanding scope of practice from physician assistants and nurses, an increased emphasis on patient volume, clinical revenue, and residency training competency requirements. We sought to demonstrate the flexibility of the family medicine workforce as shown through their scopes of practice, and argue that this is indication of their potential for redeployment during emergencies. Methods: This study computes scopes of practice for 78,416 family physicians who treat Medicare beneficiaries. We used Evaluation and Management (E/M) codes in Medicare’s 2017 Part-B public use file to calculate volumes of services done across six sites of service per physician. We aggregated counts and proportions of physicians and the E/M services they provided across sites of practice to characterize scope, and performed a separate analysis on rural physicians. Results: The study found most family physicians practicing at a single site, namely, the ambulatory clinic. However, family physicians in rural areas, where need is greater, exhibit broader scope. This suggests that a significant number of family physicians have capacity for COVID-19 deployment into other settings, such as emergency rooms or hospitals. Conclusions: Family physicians are a potential resource for emergency redeployment, however the current breadth of scope for most family physicians is not aligned with current residency training requirements and raises questions about the future of family medicine scope of practice.

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