pology) should help the student acquire a holistic approach to health and disease and to recognize the interrelationships of cultural, social, psychologi-cal, and environmental factors with the psysiological and biochemical pro-cesses of the body" (Willard Report, 1966, p. 27). Evaluation of the Mandate The important potential role of sociology in the curriculum of the family physician programs has been endorsed repeatedly before, during, and since the publication of the above-mentioned blue-ribbon commission reports (Silver, 1963, p. 74-77; GP, 1966, p. 225-246; Harrell, 1970, p. 61-64). That potential role has been greatly enhanced by the passage of the Health Educa-tion and Manpower Act in 1976, which mandated that by 1980, 50% of all medical students graduating from medical school should be entering residen-cies in the three designated primary care specialties—internal medicine, pediatrics, and family practice. An additional aspect of this act was the allocation of some $40,000,000 for the expansion and improvement of existing family medicine residencies and for the creation of additional resi-dency programs. The question at hand—almost 12 years after these recommendations were submitted to medical educators-is whether a new breed of physicians is being produced by training in family medicine. Is there a new type of physi-cian who is "aware not only of his patient's physicial illness, but also of interrelations of family members and of family and community and socio-economic factors affecting the health of family members?" (Silver, 1965, p. 188-189). There are clearly two elements that must be distinguished in evaluating this mandate to train family physicians—one quantitative and the other qualitative. As far as quantitative changes in the attention paid to training family physicians, there can be no doubt that significant shifts have occurred in the past decade. In 1967, there were only three family medicine training programs in the United States, at the Universities of Miami (Florida), Roches-ter, and Oklahoma. By 1970 there were 49 programs, in 1975 there were 233, and in 1977 there were well over 300. In 1970 family practice became a

2014 ◽  
pp. 126-132
PEDIATRICS ◽  
1975 ◽  
Vol 56 (5) ◽  
pp. 838-838
Author(s):  
R. J. H.

We are pleased that Dr. Bloom finds the contents of Pediatrics helpful as a resident in family practice. This is what we are trying to achieve—a journal that will help those who care for children, whether they be pediatricians, family physicians, or nurse practitioners. My own view about the current conflict between pediatrics and family medicine is that we need both types of physicians. There are advantages ages and disadvantages to each profession, and the strength of our position in Canada and the United States is that we can have both types of physicians providing care to children. We hope that both groups will continue to work for the best interest of children and that Pediatrics can continue to assist them in this work.


2018 ◽  
Vol 53 (5-6) ◽  
pp. 361-370 ◽  
Author(s):  
Michelle D Sherman ◽  
Stephanie A Hooker

Over five million children in the United States have a parent living with a serious mental illness. These offspring are at higher risk for developing mental health problems themselves due to a complex interplay of biological, psychological, and psychosocial factors. Life with a parent with psychiatric symptoms can be scary, confusing, overwhelming, and sad; children often blame themselves for their parent’s problems, find their parent’s behavior embarrassing, and struggle to explain the illness to their friends. Unfortunately, these children’s needs and experiences are often ignored by overwhelmed parents, worried family members and relatives, separate mental health systems of care for adults and children that often fail to coordinate care, and even well-intentioned health-care providers. Family medicine teams have an opportunity to detect and support these families in unique ways. We offer four recommendations for family medicine teams to help families managing parental mental illness including assessing functioning, treatment needs, and impacts on each family member; educating all family members about mental illness; instilling hope, noting the range of effective treatments for mental illness; and encouraging the use of supports and referral options. Providers can leverage family members’ strengths, work with community-based resources, and offer continuity to these families, as they struggle with an oftentimes chronic, relapsing disease that has ripple effects throughout the family system.


2020 ◽  
Vol 52 (6) ◽  
pp. 408-413
Author(s):  
Tyler W. Barreto ◽  
Aimee Eden ◽  
Audrey Brock

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.


Author(s):  
Jennifer Molokwu

ABSTRACT Access to timely and appropriate prenatal and maternity care is widely known to be an important factor in improving birth outcomes. Family physicians make a significant contribution to the provision of prenatal care in the United States. The amount of exposure to maternity care and prenatal procedures in residency increase likelihood of incorporation of prenatal care in future practice. The use of prenatal ultrasounds has become standard in the management of pregnancy. Ultrasonography has wide application in obstetric care and is being used in screening and diagnosis during antenatal, intrapartum and postpartum periods. Family physicians that provide obstetric care should be trained to carry out basic obstetric ultrasound scans. In our paper, we have outlined an approach to the incorporation of ultrasound training into Family Medicine residency education. We have also explored the use of simulation as an adjunct to scanning live patients in a training curriculum. How to cite this article Molokwu J. Obstetrics and Gynecology Ultrasound Topics in Family Medicine Resident Training. Donald School J Ultrasound Obstet Gynecol 2014;8(1):31-34.


2019 ◽  
Vol 51 (8) ◽  
pp. 682-686 ◽  
Author(s):  
Amanda Kost ◽  
Kimberly Kardonsky ◽  
Jeanne Cawse-Lucas ◽  
Tomoko Sairenji

Background and Objectives: An adequate family medicine workforce is needed to improve health and health care outcomes in the United States, yet few medical students in the US become family physicians. Indicators of family medicine interest upon medical school matriculation exist. Family medicine interest groups (FMIGs) may influence student choice. This study examines the association of FMIG participation with various matriculation interest indicators to predict which students go on to become family physicians. Methods: The American Medical Association Masterfile was used to identify the practice specialty of 601 graduates of the University of Washington School of Medicine who matriculated between 2003 and 2007. Graduates’ scores on the Family Medicine Interest Survey (FMIS) and whether a student listed family medicine as their top choice upon matriculation along with FMIG participation and demographic characteristics were used in a binary logistic regression model to predict eventual practice. The model output was used to calculate odds ratios and predicted probabilities of family medicine practice given initial family medicine interest and FMIG participation. Results: FMIG participation was associated with higher odds ratios and increased predicted probability of becoming a family physician regardless of initial interest although the magnitude of the difference varied. FMIG participants who listed family medicine as their top specialty had a 68% predicted probability of entering family medicine compared to 8% probability if they did not list family medicine first and did not participate in FMIG. FMIG participation was associated with odds ratios between 3.27-4.19 for entering family medicine regardless of FMIS score. Conclusions: Among University of Washington students with family medicine as their top specialty choice upon matriculation, FMIG participation was associated with higher odds of entering the specialty. The same was true, although to a lesser degree, for students who had a high score on the FMIS.


2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Grażyna Jarząbek-Bielecka ◽  
Jacek Boroch ◽  
Marek Bielecki ◽  
Witold Kędzia

Considering the issues of family medicine, it is worth noting that only few medical textbooks help understand what medicine is all about. Usually, after a brief discussion of the clinical evaluation of the patient's condition, or the doctor-patient relationship, detailed descriptions of specific disease entities are presented. Family medicine is a branch of medicine devoted to comprehensive health care for all family members who are under the care of a family practitioner. A holistic approach to the patient (also in pharmacies) is an important direction of modern medicine. A common counter-argument of the scientific view of medicine is the suggestion that it leads to the dehumanisation of medicine and limits the holistic view of the patient. These concerns are not justified as long as interdisciplinary approach is considered, which is an important aspect of family medicine. This field of medicine, the target of which is to guarantee comprehensive medical care to all family members under the care of a family practitioner, addresses the holistic approach to the patient, which is an important direction of modern medicine.


2018 ◽  
Vol 50 (9) ◽  
pp. 662-671 ◽  
Author(s):  
Jessica Taylor Goldstein ◽  
Scott G. Hartman ◽  
Matthew R. Meunier ◽  
Bethany Panchal ◽  
Christine Chang Pecci ◽  
...  

Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers.


2020 ◽  
Author(s):  
Yuji Okazaki ◽  
Shuhei Yoshida ◽  
Saori Kashima ◽  
Soichi Koike ◽  
Masatoshi Matsumoto

Abstract Background: Family physicians are known to distribute more equally among the population than other physicians. The maturity of family medicine, i.e. the length of its history as a part of healthcare system and the population of qualified family medicine experts, may affect the distribution, but this has not been shown in the literature. This study compares the geographic distribution of family physicians in Japan and the United States (U.S.), both of which are developed countries without a physician allocation system by the public sector, but the two countries differ greatly in the maturity of family medicine as a clinical specialty.Methods: This is a cross-sectional international comparative study using publicly available online database on the number of physicians in Japan (Board-certification Database of Japan Primary Care Association, and Survey of Physicians, Dentists and Pharmacists by Ministry of Health, Labour and Welfare) and the U.S. (Area Resource File by Health Resources and Services Administration). The municipalities in Japan and counties in the U.S. were divided into quintile groups according to population density. The number of family physicians per unit population in each group of areas was calculated. The geographic distribution of all physicians in Japan was simulated assuming that the proportion of family physicians among all physicians in Japan (0.16%) was increased to that in the U.S (11.8%).Results: The distribution of family physicians in Japan noticeably shifted to the areas with the lowest population density. In contrast, family physicians in the U.S. distributed equally across areas. The distribution of physicians with other specialties (general internists, pediatricians, surgeons and obstetricians/gynecologists) shifted heavily to the areas with highest population density in both countries. The simulation analysis showed the geographic maldistribution of all physicians improved substantially if the proportion of family physicians in Japan increases to that in the U.S. Conclusion: The distribution of family physicians is more equal than other medical specialists, and the immaturity of family medicine can even lead to a rural-biased distribution. In a country with emerging family medicine such as Japan, increasing the number of family physicians may effectively mitigate the urban-rural imbalance of physician supply.


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