December 2002: The Future of Family Medicine
As much of a cliché as it may be, I still find it personally helpful to spend a bit of time reflecting on past challenges and achievements at year's end. When I was given the challenge of doing this for the final Medscape editor's column of the year, I began with the question: What was the most significant event for family medicine during 2002?
To find out, I polled the Medscape Family Medicine Board members. Although I received a variety of responses, one was mentioned most frequently: The Future of Family Medicine (FFM) project, managed by the American Academy of Family Physicians (AAFP), and a joint effort of the Family Practice Working Party and the Academic Family Medicine Organizations.
This multifaceted undertaking, which began in 2002, will not be completed until 2004. During a recent interview with James Martin, MD, chair of the Project Leadership Committee, he described how the need for the project grew from an uneasy feeling: "Family physicians were feeling frustrated in their work, and the question was raised about whether their care was the problem or the healthcare system was the problem."
Family Medicine was created in 1969, following several seminal papers calling for a new specialty to meet people's needs for renewal of the generalist function in medicine, for a whole-person focus, and for continuity of care that was comprehensive and coordinated. More than 30 years later, it was time to assess whether these core attributes were still integral to both how physicians approached their practice and to the patients they care for. Martin noted that of specific concern was whether family physicians were perceived as having academic prowess and technical skills, or were just viewed as "feel-good docs," and whether Americans still valued care from a physician with whom they had a personal, ongoing relationship.
The FFM project has 3 phases. Phase 1, completed this year, consisted of national market research to evaluate what people need, want, and expect from family physicians and from primary care. It also involved soliciting opinions from family physicians, medical subspecialists, medical students, residents, payors, and others. In phase 2, 5 task forces will use these data gathered during 2002 to determine future direction for family practice and specific ways to achieve established goals. The respective focuses of the groups will be to:
Phase 3, implementation, will begin in the fall of 2003 and continue into 2004.
An overview of the FFM project is available at http://www.futurefamilymed.org/ This site will be updated continually as the project progresses.
As lofty and laudable as the FFM project may be, what makes it the most important event of 2002 for family medicine? First, it is always significant whenever any group takes a comprehensive, objective look at itself. In addition, this project not only solicited opinions from physicians and other health professionals, but from consumers as well. As Desiree Lie, MD, MSEd, a Medscape board member, expressed, "It is quite an undertaking, and it will take a lot of courage and support to see this project through. I think it speaks well of our specialty to take this honest and clear look at what the public thinks of us."
Second, it appears to be the serious intent of this coalition to use the findings from this project to make necessary -- perhaps even sweeping -- changes in how family medicine will be defined and practiced in the future.
Some outcomes were not unexpected, and reinforce core values long attributed to family practice physicians and held as important to patients. These include attending to both physical and emotional health, knowing the patient as a person, being able to know and provide care to entire families, encouraging a healthier lifestyle and acting as a partner in maintaining health, and offering understanding and support. Another reassuring finding was that family physicians are remarkably satisfied with their chosen profession; 90% of those polled agreed with the statement "I have no doubt I chose the right specialty in selecting family medicine." (Personal communication, Norman Kahn, MD, AAFP Vice President for Science and Education; December 9, 2002)
Other findings did not resonate with core values. For example, although the physician-patient relationship was valued, patients indicated that the expectation of continuity of care might be unrealistic in the current mobile society, and/or in an insurance climate where frequent change is the norm. Other findings reflected what has been called the "fast food" approach to healthcare, where convenience and availability take precedence over quality and comprehensiveness.
The majority of data obtained during 2002 is currently embargoed, but will be available by the early spring of next year. According to Kahn (personal communication, December 9, 2002), the FFM project members will use findings to " ... evolve and enhance the practice, role, and training of family physicians, and to make practice even more effective and satisfying for both patients and family physicians."
More to come from this historic project in 2003.
Happy Holidays and best wishes for a happy, healthy New Year.
If you have comments or questions about the site, please contact me at familyeditor@webmd.net
As much of a cliché as it may be, I still find it personally helpful to spend a bit of time reflecting on past challenges and achievements at year's end. When I was given the challenge of doing this for the final Medscape editor's column of the year, I began with the question: What was the most significant event for family medicine during 2002?
To find out, I polled the Medscape Family Medicine Board members. Although I received a variety of responses, one was mentioned most frequently: The Future of Family Medicine (FFM) project, managed by the American Academy of Family Physicians (AAFP), and a joint effort of the Family Practice Working Party and the Academic Family Medicine Organizations.
This multifaceted undertaking, which began in 2002, will not be completed until 2004. During a recent interview with James Martin, MD, chair of the Project Leadership Committee, he described how the need for the project grew from an uneasy feeling: "Family physicians were feeling frustrated in their work, and the question was raised about whether their care was the problem or the healthcare system was the problem."
Family Medicine was created in 1969, following several seminal papers calling for a new specialty to meet people's needs for renewal of the generalist function in medicine, for a whole-person focus, and for continuity of care that was comprehensive and coordinated. More than 30 years later, it was time to assess whether these core attributes were still integral to both how physicians approached their practice and to the patients they care for. Martin noted that of specific concern was whether family physicians were perceived as having academic prowess and technical skills, or were just viewed as "feel-good docs," and whether Americans still valued care from a physician with whom they had a personal, ongoing relationship.
The FFM project has 3 phases. Phase 1, completed this year, consisted of national market research to evaluate what people need, want, and expect from family physicians and from primary care. It also involved soliciting opinions from family physicians, medical subspecialists, medical students, residents, payors, and others. In phase 2, 5 task forces will use these data gathered during 2002 to determine future direction for family practice and specific ways to achieve established goals. The respective focuses of the groups will be to:
determine core attributes, reform family practice to meet consumer expectations, and determine optimal systems of care delivery;
determine the training needed for family physicians to facilitate delivery of core attributes and appropriate system services;
ensure the delivery of core attributes throughout the careers of family physicians;
communicate the role of the family physician within medicine and healthcare and to purchasers and consumers; and
to determine the role of family practice leadership in shaping the healthcare delivery system of the future.
Phase 3, implementation, will begin in the fall of 2003 and continue into 2004.
An overview of the FFM project is available at http://www.futurefamilymed.org/ This site will be updated continually as the project progresses.
As lofty and laudable as the FFM project may be, what makes it the most important event of 2002 for family medicine? First, it is always significant whenever any group takes a comprehensive, objective look at itself. In addition, this project not only solicited opinions from physicians and other health professionals, but from consumers as well. As Desiree Lie, MD, MSEd, a Medscape board member, expressed, "It is quite an undertaking, and it will take a lot of courage and support to see this project through. I think it speaks well of our specialty to take this honest and clear look at what the public thinks of us."
Second, it appears to be the serious intent of this coalition to use the findings from this project to make necessary -- perhaps even sweeping -- changes in how family medicine will be defined and practiced in the future.
Some outcomes were not unexpected, and reinforce core values long attributed to family practice physicians and held as important to patients. These include attending to both physical and emotional health, knowing the patient as a person, being able to know and provide care to entire families, encouraging a healthier lifestyle and acting as a partner in maintaining health, and offering understanding and support. Another reassuring finding was that family physicians are remarkably satisfied with their chosen profession; 90% of those polled agreed with the statement "I have no doubt I chose the right specialty in selecting family medicine." (Personal communication, Norman Kahn, MD, AAFP Vice President for Science and Education; December 9, 2002)
Other findings did not resonate with core values. For example, although the physician-patient relationship was valued, patients indicated that the expectation of continuity of care might be unrealistic in the current mobile society, and/or in an insurance climate where frequent change is the norm. Other findings reflected what has been called the "fast food" approach to healthcare, where convenience and availability take precedence over quality and comprehensiveness.
The majority of data obtained during 2002 is currently embargoed, but will be available by the early spring of next year. According to Kahn (personal communication, December 9, 2002), the FFM project members will use findings to " ... evolve and enhance the practice, role, and training of family physicians, and to make practice even more effective and satisfying for both patients and family physicians."
More to come from this historic project in 2003.
Happy Holidays and best wishes for a happy, healthy New Year.
If you have comments or questions about the site, please contact me at familyeditor@webmd.net
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