scholarly journals Opportunities and Barriers for Family Physician Contribution to the Maternity Care Workforce

2019 ◽  
Vol 51 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Tyler W. Barreto ◽  
Aimee Eden ◽  
Elizabeth Rose Hansen ◽  
Lars E. Peterson
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
Early Career ◽  
Certification Examination ◽  
Obstetrical Care ◽  
New Graduates ◽  
Middle Atlantic ◽  
South Central ◽  
Central Regions ◽  
Recent Graduates

Background and Objectives: The number of family physicians providing obstetric deliveries is decreasing, but high numbers of new graduates report they intend to include obstetric deliveries in their practices. The objective of this study was to understand barriers to providing obstetrical care faced by recent family medicine residency graduates who intended to provide obstetrical care at graduation. Methods: Email surveys were sent to graduating family medicine residents who indicated intention to include obstetrics in their practice on the American Board of Family Medicine (ABFM) Certification Examination Registration Survey (2014-2016). We used descriptive and bivariate statistics to analyze the data. Results: Of our sample of 2,098 early career family physicians, 1,016 (48.4%) responded. Seven hundred (68.9%) currently include obstetrics in their practices. Those currently including obstetrics were more likely to practice in a small rural or isolated (15.4% vs 5.2% and 4.6% vs 1.7%, P<0.001) community and report credentialing was easy (85.2% and 26.5%, respectively, P<0.001). Physicians not currently including obstetrics in their practice reported “found a job without OB” and “lifestyle concerns” as the most significant barriers. Respondents living in the Middle Atlantic and West South Central regions were least likely to provide obstetric deliveries, with fewer than 50% doing so. Conclusions: Among recent graduates who intended to practice obstetrics, finding a job without obstetrics and lifestyle concerns were the most significant barriers to realizing the scope of practice they intended.

scholarly journals Exposure of Domestic Cats to Three Zoonotic Bartonella Species in the United States

Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 354
Author(s):  
Lynn M. Osikowicz ◽  
Kalanthe Horiuchi ◽  
Irina Goodrich ◽  
Edward B. Breitschwerdt ◽  
Bruno Chomel ◽  
...  
Keyword(s):  
New England ◽  
The United States ◽  
Severe Illness ◽  
Domestic Cats ◽  
Bartonella Species ◽  
Serum Samples ◽  
North Central ◽  
Middle Atlantic ◽  
South Central ◽  
Central Regions

Cat-associated Bartonella species, which include B. henselae, B. koehlerae, and B. clarridgeiae, can cause mild to severe illness in humans. In the present study, we evaluated 1362 serum samples obtained from domestic cats across the U.S. for seroreactivity against three species and two strain types of Bartonella associated with cats (B. henselae type 1, B. henselae type 2, B. koehlerae, and B. clarridgeiae) using an indirect immunofluorescent assay (IFA). Overall, the seroprevalence at the cutoff titer level of ≥1:64 was 23.1%. Seroreactivity was 11.1% and 3.7% at the titer level cutoff of ≥1:128 and at the cutoff of ≥1:256, respectively. The highest observation of seroreactivity occurred in the East South-Central, South Atlantic, West North-Central, and West South-Central regions. The lowest seroreactivity was detected in the East North-Central, Middle Atlantic, Mountain, New England, and Pacific regions. We observed reactivity against all four Bartonella spp. antigens in samples from eight out of the nine U.S. geographic regions.

scholarly journals The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians

2020 ◽  
Vol 52 (6) ◽  
pp. 408-413
Author(s):  
Tyler W. Barreto ◽  
Aimee Eden ◽  
Audrey Brock
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
The United States ◽  
Early Career ◽  
Residency Programs ◽  
Complex Patients ◽  
Semistructured Interviews ◽  
Administrative Tasks ◽  
The Impact ◽  
The Relationship

Background and Objectives: According to a previous study, obstetric deliveries may be protective against burnout for family physicians. Analyses of interviews conducted during a larger qualitative study about the experiences of early-career family physicians who intended to include obstetric deliveries in their practice revealed that many interviewees discussed burnout. This study aimed to understand the relationship between practicing obstetrics and burnout based on an analysis of these emerging data on burnout. Methods: We conducted semistructured interviews with physicians who graduated from family medicine residency programs in the United States between 2013 and 2016. We applied an immersion-crystallization approach to analyze transcribed interviews. Results: Fifty-six early-career family physicians participated in interviews. Burnout was an emerging theme. Physicians described how practicing obstetrics can protect from burnout (eg, brings joy to practice, diversity in practice), how it can contribute to burnout (eg, time demands, increased stress), how it can do both simultaneously and the importance of professional agency (ie, the capacity to make own free choices), and other sources of burnout (eg, administrative tasks, complex patients). Conclusions: This study identifies a family medicine-obstetric paradox wherein obstetrics can simultaneously protect from and contribute to burnout for family physicians. Professional agency may partially explain this paradox.

scholarly journals Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants

2019 ◽  
Vol 51 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Mingliang Dai ◽  
Richard C. Ingham ◽  
Lars E. Peterson
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Nurse Practitioners ◽  
Family Physicians ◽  
Physician Assistants ◽  
Scope Of Practice ◽  
Certification Examination ◽  
Panel Size ◽  
Practice Characteristics ◽  
Number Of Patients

Background and Objectives: Little is known about how the presence of nurse practitioners (NPs) and physician assistants (PAs) in a practice impacts family physicians’ (FPs’) scope of practice. This study sought to examine variations in FPs’ practice associated with NPs and PAs. Methods: We obtained data from American Board of Family Medicine practice demographic questionnaires completed by FPs who registered for the Family Medicine Certification Examination during 2013-2016. Scope of practice score was calculated for each FP, ranging from 0-30 with higher numbers equating to broader scope of practice. FPs self-reported patient panel size. Primary care teams were classified into NP only, PA only, both NP and PA, or no NP or PA. We estimated variation in scope and panel size with different team configurations in regression models. Results: Of 27,836 FPs, nearly 70% had NPs or PAs in their practice but less than half (42.5%) estimated a panel size. Accounting for physician and practice characteristics, the presence of NPs and/or PAs was associated with significant increases in panel sizes (by 410 with PA only, 259 with NP only and 245 with both; all P<0.05) and in scope score (by 0.53 with PA only, 0.10 with NP only and 0.51 with both; all P<0.05). Conclusions: We found evidence that team-based care involving NPs and PAs was associated with higher practice capacity of FPs. Working with PAs seemed to allow FPs to see a greater number of patients and provide more services than working with NPs. Delineation of primary care team roles, responsibilities and boundaries may explain these findings.

A human resources for health analysis of registered family medicine specialists in South Africa: 2002–19

2020 ◽  
Author(s):  
Ritika Tiwari ◽  
Robert Mash ◽  
Innocent Karangwa ◽  
Usuf Chikte
Keyword(s):  
South Africa ◽  
Health Policy ◽  
Family Medicine ◽  
Human Resources ◽  
Human Resources For Health ◽  
Family Physicians ◽  
Medical Practitioners ◽  
The Public ◽  
New Graduates ◽  
Training Programmes

Abstract Background In South Africa, there is a need to clarify the human resources for health policy on family physicians (FPs) and to ensure that the educational and health systems are well aligned in terms of the production and employment of FPs. Objective To analyse the human resource situation with regard to family medicine in South Africa and evaluate the requirements for the future. Methods A retrospective review of the Health Professions Council of South Africa’s (HPCSA) database on registered family medicine practitioners from 2002 until 2019. Additional data were obtained from the South African Academy of Family Physicians and published research. Results A total of 1247 family medicine practitioners were registered with the HPCSA in 2019, including 969 specialist FPs and 278 medical practitioners on a discontinued register. Of the 969, 194 were new graduates and 775 from older programmes. The number of FPs increased from 0.04/10 000 population in 2009 to 0.16/10 000 in 2019, with only 29% in the public sector. On average, seven registrars entered each of nine training programmes per year and three graduated. New graduates and registrars reflect a growing diversity and more female FPs. The number of FPs differed significantly in terms of age, gender, provincial location and population groups. Conclusions South Africa has an inadequate supply of FPs with substantial inequalities. Training programmes need to triple their output over the next 10 years. Human resources for health policy should substantially increase opportunities for training and employment of FPs.

scholarly journals Mindsets of Early-Career Family Physicians Trained in Competency-Based Education

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Mao Ding ◽  
Sudha Koppula ◽  
Olga Szafran ◽  
Lillian Au ◽  
Oksana Babenko
Keyword(s):  
Clinical Practice ◽  
Family Medicine ◽  
Family Physicians ◽  
Well Being ◽  
Early Career ◽  
Survey Study ◽  
Competency Based Education ◽  
Competency Based ◽  
Over Time ◽  
Family Medicine Residents

Introduction: The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. Methods: This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al’s instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). Conclusion: Family physicians trained in competency-based education continued to be mastery-oriented in the first 3 years of clinical practice. This finding is reassuring given that the mastery mindset is associated with professional well-being and long-term success. Nonetheless, because mastery mindset scores appeared to decrease over time, residency programs need to ensure graduating residents are equipped with knowledge and tools to remain mastery-oriented throughout the course of their professional careers.

scholarly journals HIV Care by Early-Career Family Physicians

2021 ◽  
Vol 53 (9) ◽  
pp. 760-765
Author(s):  
Kento Sonoda ◽  
Zachary J. Morgan ◽  
Lars E. Peterson
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
Personal Characteristics ◽  
Female Gender ◽  
Hiv Prevalence ◽  
Early Career ◽  
Hiv Care ◽  
Graduate Survey ◽  
Practice Characteristics ◽  
Current Provision

Background and Objectives: Antiretroviral treatment has transformed human immunodeficiency virus (HIV) infection into a chronic disease. Prior research demonstrated a discrepancy between preparation to provide HIV care and current provision among recent residency graduates. Our study aimed to describe characteristics related to preparedness and provision of HIV care, and to identify the associations between physician and practice characteristics with current provision of HIV care among those prepared. Methods: We obtained data from the 2016 through 2019 American Board of Family Medicine (ABFM) National Family Medicine Graduate Survey. Our main outcome was self-reported provision of HIV care. Bivariate statistics compared differences in personal and practice characteristics with self-reported preparation for HIV care, then among those prepared, provision of HIV care. We used logistic regression to determine associations between HIV care, among those prepared, with practice and personal characteristics. Results: The response rate was 68.7% and our final sample size was 6,740 respondents. Only 25% of respondents reported preparedness in residency, and 44% of them reported current provision. Among those prepared, female gender (OR=0.604; 95% CI, 0.494-0.739) was associated with lower odds of practicing HIV care. Those working in high HIV prevalence areas (OR=1.718; 95% CI, 1.259-2.344) and in Northeast census region (OR=1.557; 95% CI, 1.137-2.132) had higher odds of providing HIV care. Conclusions: Fewer than half of those prepared in residency reported currently providing HIV care. Working in a high HIV prevalence area was associated with higher odds of providing HIV care, which suggests early-career family physicians are responding to community needs.

Psychosocial Beliefs of Medical Students Planning to Specialize in Family Medicine

1997 ◽  
Vol 80 (3) ◽  
pp. 987-992 ◽  
Author(s):  
Fred W. Markham ◽  
James J. Diamond
Keyword(s):  
Internal Medicine ◽  
Medical Students ◽  
Family Medicine ◽  
Family Physicians ◽  
Female Students ◽  
Further Training ◽  
Senior Year ◽  
Family Doctors ◽  
Fourth Year Medical Students ◽  
Belief Scale

The psychosocial orientation of fourth-year medical students planning careers in family medicine was compared to those selecting other specialities using the Physician Belief Scale. This scale has shown that practicing family physicians have a greater psychosocial orientation than those in other specialities such as internal medicine. The current study was done to see whether students choosing family medicine already have this greater orientation before they begin training as residents. 664 fourth-year medical students received surveys during their senior year and 378 (57%) returned completed surveys. Female students had a significantly greater psychosocial orientation than their male peers, but there were no significant differences between students planning residencies in family medicine and those selecting other residencies. The greater orientation of family doctors would appear to be a product of further training and experience either during residency or later during the actual practice of family medicine.

Early career development in the public sector: Lessons from a social constructionist perspective

2017 ◽  
Vol 26 (2) ◽  
pp. 43-51
Author(s):  
Todd Bridgman ◽  
Annie De’ath
Keyword(s):  
Social Constructionism ◽  
Meaning Making ◽  
Research Process ◽  
Early Career ◽  
Social Constructionist ◽  
Small Scale ◽  
State Sector ◽  
Recent Graduates ◽  
Context Specific ◽  
Collective Construction

This article explores the contribution a social constructionist paradigm can make to the study of career, through a small-scale empirical study of recent graduates employed in New Zealand’s state sector. A social constructionist lens denies the possibility of an individualised, generalised understanding of ‘career’, highlighting instead its local, contingent character as the product of social interaction. Our respondents’ collective construction of career was heavily shaped by a range of context-specific interactions and influences, such as the perception of a distinctive national identity, as well as by their young age and state sector location. It was also shaped by the research process, with us as researchers implicated in these meaning-making processes. Social constructionism shines a light on aspects of the field that are underplayed by mainstream, scientific approaches to the study of career, and therefore has valuable implications for practitioners, as well as scholars.

scholarly journals Emergency medicine training demographics of physicians working in rural and regional southwestern Ontario emergency departments

CJEM ◽  
2007 ◽  
Vol 9 (06) ◽  
pp. 449-452 ◽  
Author(s):  
Munsif Bhimani ◽  
Gordon Dickie ◽  
Shelley McLeod ◽  
Daniel Kim
Keyword(s):  
Emergency Medicine ◽  
Family Medicine ◽  
Residency Training ◽  
Emergency Departments ◽  
Training Programs ◽  
Family Physicians ◽  
Demographic Information ◽  
Trauma Resuscitation ◽  
Curriculum Content

ABSTRACT Objectives: We sought to determine the emergency medicine training demographics of physicians working in rural and regional emergency departments (EDs) in southwestern Ontario. Methods: A confidential 8-item survey was mailed to ED chiefs in 32 community EDs in southwestern Ontario during the month of March 2005. This study was limited to nonacademic centres. Results: Responses were received from 25 (78.1%) of the surveyed EDs, and demographic information on 256 physicians working in those EDs was obtained. Of this total, 181 (70.1%) physicians had no formal emergency medicine (EM) training. Most were members of the College of Family Physicians of Canada (CCFPs). The minimum qualification to work in the surveyed EDs was a CCFP in 8 EDs (32.0%) and a CCFP with Advanced Cardiac and Trauma Resuscitation Courses (ACLS and ATLS) in 17 EDs (68.0%). None of the surveyed EDs required a CCFP(EM) or FRCP(EM) certification, even in population centres larger than 50 000. Conclusion: The majority of physicians working in southwestern Ontario community EDs graduated from family medicine residencies, and most have no formal EM training or certification. This information is of relevance to both family medicine and emergency medicine residency training programs. It should be considered in the determination of curriculum content and the appropriate number of residency positions.

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