Family medicine
[9] American Board of Family Medicine requires its diplomates to maintain certification through an ongoing process of continuing medical education, medical knowledge review, patient care oversight through chart audits, practice-based learning through quality improvement projects and retaking the board certification examination every 7 to 10 years.
The American Osteopathic Board of Family Physicians requires its diplomates to maintain certification and undergo the process of recertification every 8 years.
In addition to diagnosing and treating illness, they also provide preventive care, including routine checkups, health-risk assessments, immunization and screening tests, and personalized counselling on maintaining a healthy lifestyle.
[12] Family doctors also practice safety-netting, which involves follow-up assessments for uncertain diagnoses associated with symptoms that could innocuous, but may also be a sign of serious illness.
Today, family physicians provide more care for America's underserved and rural populations than any other medical specialty.
First, medical specialties and subspecialties increased in popularity, having an adverse effect on the number of physicians in general practice.
Three hundred hours of continuing medical education within the prior six years is also required to be eligible to sit for the exam.
[27] Many sources cite a shortage of family physicians (and also other primary care providers, i.e. internists, pediatricians, and general practitioners).
[32][33] The initiative is termed the "25 x 2030 Student Choice Collaborative", and the following eight family medicine organizations have committed resources to reaching this goal: The waning interest in family medicine in the U.S. is likely due to several factors, including the lesser prestige associated with the specialty, the lesser pay, the limited ACGME approved fellowship opportunities, and the increasingly frustrating practice environment.
[35] Family physicians are trained to manage acute and chronic health issues for an individual simultaneously, yet their appointment slots may average only ten minutes.
[36] In addition to facing a shortage of personnel, physicians in family medicine experience some of the highest rates of burnout among medical specialties, at 47 percent.
About half of the 1,011 respondents thought their surgeries were not suitable for present needs, and 78% said they would not be able to handle expected future demands.
[50] Under the pressure of the Coronavirus epidemic in 2020 general practice shifted very quickly to remote working, something which had been progressing very slowly up to that point.
[52] The GP Forward View, published by NHS England in 2016 promised £2.4 billion (14%) real-terms increase in the budget for general practice.
[53] In July Simon Stevens announced a programme designed to recruit around 2,000 GPs from the EU and possibly New Zealand and Australia.
[56] There are also moves to employ care navigators, sometimes an enhanced role for a receptionist, to direct patients to different services such as pharmacy and physiotherapy if a doctor is not needed.
[65] Commercial providers are rare in the UK but a private GP service was established at Poole Road Medical Centre in Bournemouth in 2017 where patients can pay to skip waiting lists to see a doctor.
Patients with long term medical conditions or who might need home visits were actively discouraged from joining the service.
Richard Vautrey warned that it risked 'undermining the quality and continuity of care and further fragmenting the service provided to the public'.
[68] 85% of patients rate their overall experience of primary care as good in 2016, but practices run by limited companies operating on APMS contracts (a small minority) performed worse on four out of five key indicators - frequency of consulting a preferred doctor, ability to get a convenient appointment, rating of doctor communication skills, ease of contacting the practice by telephone and overall experience.
[70] The British Medical Association collected undated resignation letters in 2017 from GPs who threatened to leave the NHS and charge consultation fees.
There is a move to incorporate other health professionals such as pharmacists in to general practice to provide an integrated multidisciplinary healthcare team to deliver primary care.
There is a severe shortage of postgraduate training seats, causing a lot of struggle, hardship and a career bottleneck for newly qualified doctors just passing out of medical school.
The National Board of Examinations conducts family medicine residency programmes at the teaching hospitals that it accredits.
On successful completion of a three-year residency, candidates are awarded Diplomate of National Board (Family Medicine).
[citation needed] The Indian Medical Association's College of General Practitioners, offers a one-year Diploma in Family Medicine (DFM), a distance education programme of the Postgraduate Institute of Medicine, University of Colombo, Sri Lanka, for doctors with minimum five years of experience in general practice.
[82] Some projects like "Buzurgo Ka Humsafar" aid in the growing need for primary care by conducting social awareness workshops and adult vaccination camps.
A group of 15 doctors based in Birmingham have set up a social enterprise company - Pathfinder Healthcare - which plans to build eight primary health centres in India on the British model of general practice.
Japan has a free access healthcare system meaning patients can bypass primary care services.
[90] A review literature has recently been published detailing the context, structure, process, and outcome of family medicine in Japan.
