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3. Family Medicine (Important and It’s Future) R.Askari Ph.D. Student in Health Services Management Email: r.asqari@yahoo.com 3

4. Your Future is Family Medicine Information, facts and answers to frequently asked questions about family medicine 4

5. Why is primary care important?  longer life spans and fewer deaths due to heart and lung disease  fewer cases and deaths due to colon and cervical cancer  better detection of breast cancer  less hospital use  better preventive care  reduced health disparities 5

6. What do family physicians do? Family physicians provide comprehensive and continuous primary care health care to:  individuals and families  women and men regardless of age or disease  infants, children and adolescents regardless of disease 6

7. Family physicians provide  Prevention & management of acute injuries and illnesses  Health promotion  Hospital care for acute medical illnesses  Chronic disease management  Maternity care  Well-child care and child development  Primary mental health care  Rehabilitation  Supportive and end-of-life care 7

8. What FP attributes are valued?  Deep understanding of the whole person  Act as a partner to patients over many years  Talent for humanizing health care  A command of complexity Source: Martin JC, Avant RF, Bowman MA, et al. The Future of Family Medicine: A collaborative project of the family medicine community. Ann Fam Med. 2004 Mar-Apri; 2 Suppl 1:53-32 8

9. Family physicians’ whole-person orientation and training ensures that FPs…  Consider all of the influences on a person’s health  Know and understand peoples’ limitations, problems and personal beliefs when deciding on a treatment  Are appropriate and efficient in proposing therapies and interventions  Develop rewarding relationships with patients 9

10. Family physicians have a unique influence on patients’ lives  Serving as partner with patients to maintain well-being over time  Empowering with information and guidance that are needed to maintain health over time  Providing care that includes long-term behavioral change interventions that lead to better health  Developing ongoing communication between patient and physician 10

11. Family physicians are relationship-oriented, which ensures…  Good relationships with other physicians and health care providers.  Better patient understanding of complex medical issues and improved participation in the care process.  Less expensive and better healthcare experience for patient. 11

12. Family physicians have a natural command of complexity and  Thrive on managing complex medical problems  Integrate all of the medical and personal issues facing an individual  Break down medical terms and complex medical issues to make it easier for patients to understand 12

13. How are family physicians trained?  3 years  More than 400 family medicine residencies  Community-based  Medical school-based  Military  Inner-city  Urban  Suburban  Rural  Innovative Training Models

14. Family medicine residency clinical curriculum Adult medicineCritical care medicine Maternity careGynecologic care General surgeryOrthopedics Emergency careCare of children Skin careHuman behavior Women’s healthNewborn care Continuity Patient Care – all 3 years 14

15. What are the primary care specialties? Source: DA, Cherry DK. National Ambulatory Medical Care Survey: 2005 Summary. Advance Data from Vital and Health Statistics; No. 346, Hyattsville, Maryland: National Center for Health Statistics. 2004. http://www.cdc.gov/nchs/about/major/ahcd/officevisitcharts.htm. 15

16. What distinguishes family physicians from general internists? Ages and gender of patients seen by family physicians and general internists Source: National Center for Health Statistics: Chart book on Trends in the health of Americans: 2006 16

17. What’s a typical week in primary care? Source: National Ambulatory Medical Care Survey: 2004 Summary. National Center for Health Statistics 17

18. People rely on primary care physicians to care for complex disease Source: 2002 National Health Interview Survey ConditionSaw a PC physician in the last year Asthma80% Congestive Heart Failure88% Coronary Heart Disease88% Depression/Anxiety81% Diabetes88% Hypertension88% Multiple Sclerosis77% Parkinson’s90% 18

19. What’s a typical week in family medicine? Source: National Ambulatory Medical Care Survey: 2005 Summary. National Center for Health Statistics 19

20. Lifestyle of Family Physicians?  39.7 hours per week in direct patient care 1  50 hours per week in patient related activities  Avg. wks worked – 46.9 weeks 1  5 weeks for vacation/CME 1  Avg. Income for 2006: $161,000 2 1 AAFP Facts About Family Medicine. 2006 http://www.aafp.org/facts.xml 2 Merritt Hawkins & Assoc. 2007 Review of Physician and CRNA Recruiting Incentives. Oct 2007. 20

21. Are family physicians in demand?  The Number One most recruited specialty in 2006  The primary care specialty most in demand  35% increase in recruitment of family physicians in 2004 1 Merritt Hawkins & Assoc. 2007 Review of Physician and CRNA Recruiting Incentives. Oct 2007 2 Hawkins, J. Encouraging news about family physician recruitment. Family Practice Management. 2005 Apr; 12(4); 56-8. 21

22. The WHO framework statement General Continuous Comprehensive Coordinated Collaborative Family orientated Community orientated 22

23. The principles of the discipline as suggested by Gay Patient centered approach Orientation on family and community context Field of activities determined by patient needs and requests Unselected and complex health problems Low incidence of serious diseases Diseases at early stage Continuing management Coordinated care Efficiency 23

24. The WONCA 1991 statement includes the following Comprehensive care Orientation to the patient Family focus Doctor/patient relationship Co-ordination with other services Advocacy Accessibility resource management. 24

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33. What’s the future of family medicine?  Electronic health record (EHR)  Online appointments  Web-based patient education  E-visits 33

34. Innovations in family medicine  Group visits  Team approach to care  Systematic approach to care  Chronic disease management 34

35. Future of family medicine  Market research  Six task forces  Family medicine’s new model of care  Personal medical home  Continuous relationship  Basket of services 35

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