Student Fm Presentation 2007

8/7/2019 Student Fm Presentation 2007

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Your Future is Family Your Future is FamilyMedicineMedicine

Information, facts and answers toInformation, facts and answers tofrequently asked questions aboutfrequently asked questions about

family medicinefamily medicine


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Wh at are t h e primary careWh at are t h e primary carespecialties?specialties?

Source: DA, C h erry DK. National Ambulatory Medical Care Survey: 2005 Summary. AdvanceData from Vital and Healt h Statistics; No. 346, Hyattsville, Maryland: National Center for Healt h Statistics. 2004. h ttp://www.cdc.gov/nc h s/about/major/a h cd/officevisitc h arts. h tm .

216

168129

573

390

0

100

200

300

400

500

600

Millions

F

M

M

P

A P

C O h

Sp

T h e Primary Care P h ysicianN

O

!

V " #

" #

P $ % C $ Ph % " ! $ & " v" . O#

h Sp ! $ ' " #

"


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Wh ats a typical week in primaryWh ats a typical week in primarycare?care?

Source: National Ambulatory Medical Care Survey: 2004 Summary. National Center for Healt h Statistics

Ma or Reasons for isits to rimary Care Specialists

11 5

34 7

32 6

87

0 20 40 60 80 100

Injury Related

Chronic Condition

Acute Condition

Preventive

R e a s o n s

f o r

i s i t s

ercenta e


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Wh y is primary care important?Wh y is primary care important?

longer life s ans and fewer deat s due to eartlonger life s ans and fewer deat s due to eartand lung diseaseand lung diseasefewer cases and deat s due to colon andfewer cases and deat s due to colon andcer ical cancer cer ical cancer better detection of breast cancer better detection of breast cancer less ER and os ital useless ER and os ital use

better re enti e carebetter re enti e carereduced ealt dis aritiesreduced ealt dis arities


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Wh at do family p h ysicians do?Wh at do family p h ysicians do?

F amily ysicians ro ide com re ensi e andF amily ysicians ro ide com re ensi e andcontinuous rimary care ealt care to:continuous rimary care ealt care to:

indi iduals and familiesindi iduals and families

women and men regardless of age or diseasewomen and men regardless of age or disease

infants, c ildren and adolescents regardless of infants, c ildren and adolescents regardless of diseasedisease


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P rocedures performed by familyP rocedures performed by familyp h ysiciansp h ysicians

A rterial lines A rterial linesA udiometry A udiometry

astingastingentral linesentral linesolonosco yolonosco yol osco y/LEE PC ol osco y/LEE P

EKGEKGExcisions of moles, ne i,Excisions of moles, ne i,cysts, warts, skin tagscysts, warts, skin tagsEndosco yEndosco yIntubationIntubationJoint InjectionsJoint Injections

P aracentesisP aracentesisP a mearsP a mearsP ulmonary functionP ulmonary functiontestingtestingP unc bio siesP unc bio sies

kin bio sieskin bio siesirometryirometry

uturing lacerationsuturing lacerations

T oracentesisT oracentesisUltrasound imagingUltrasound imagingTym anometryTym anometry

asectomyasectomy


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Wh at distinguis h es family p h ysiciansWh at distinguis h es family p h ysiciansfrom general internists?from general internists?

isits y men to primary care p h ysicians -

0.0%5.0%

10.0%15.0%20.0%25.0%

30.0%35.0%

Under 18 18-44 years 45-64 years 65 year andover

Family Medicine

Internal Medicine

A ges and A ges andgender o f gender o f patients seenpatients seen

by f amilyby f amilyphysicians andphysicians andgeneralgeneralinternistsinternists

Source:Source:National Center for National Center for Healt h Statistics:Healt h Statistics:Ch art ook on rendsCh art ook on rendsin t h e h ealt h of in t h e h ealt h of Americans:Americans:

i s i t s y o m e n t o p r i m a r y c a r e p h y s ic i a n s -

0 . 0 %

5 . 0 %

1 0 . 0 %

1 5 . 0 %

2 0 . 0 %

2 5 . 0 %

3 0 . 0 %

U n d e r 1 8 1 8 -4 4

y e a r s

4 5 - 6 4

y e a r s

6 5 y e a r

a n d o v e r

F a m i l y M e d i c i n e

In t e r n a l M e d i c i n e


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P ercentage of C h ildrens Office VisitsP ercentage of C h ildrens Office Visitsby Specialtyby Specialty

Sources:

National Ambulatory Medical Care Surveys, 1992 2002

AAF P ask Force On t h e Care of C h ildren, 2005


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Wh at F P attributes are valued?Wh at F P attributes are valued?

Dee p understanding of t he w hole personDee p understanding of t he w hole person

A ct as a partner to patients o er many years A ct as a partner to patients o er many years

Talent for humanizing healt h careTalent for humanizing healt h care

A command of com p lexity A command of com p lexity

Source:Source:Martin JC, Avant F, Bowman MA, et al. h e Future of Family Medicine: AMartin JC, Avant F, Bowman MA, et al. h e Future of Family Medicine: Acollaborative project of t h e family medicine community. Ann Fam Med. 2004 Mar collaborative project of t h e family medicine community. Ann Fam Med. 2004 Mar Apri; 2 Suppl 1:53Apri; 2 Suppl 1:53 32 32


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Family p h ysicians w h oleFamily p h ysicians w h ole person orientationperson orientationand training ensures t h at F P sand training ensures t h at F P s

C onsider C onsider allall of the influences on a personsof the influences on a personshealt hhealt h

Know and understand peo p les limitations,Know and understand peo p les limitations,problems and personal beliefs w hen decidingproblems and personal beliefs w hen decidingon a treatmenton a treatmentA re a pp ropriate and efficient in proposing A re a pp ropriate and efficient in proposingthera p ies and inter entionsthera p ies and inter entionsDe elo p rewarding relations h ips with patientsDe elo p rewarding relations h ips with patients


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Family p h ysicians h ave a uniqueFamily p h ysicians h ave a unique

influence on patients livesinfluence on patients livesS er ing as partner wit h patients to maintain wellS er ing as partner wit h patients to maintain well- -being o er timebeing o er time

Em powering wit h information and guidance t hatEm powering wit h information and guidance t hatare needed to maintain healt h o er timeare needed to maintain healt h o er time

P ro iding care t hat includes longP ro iding care t hat includes long- -termtermbe ha ioral c hange inter entions t hat lead tobe ha ioral c hange inter entions t hat lead tobetter healt hbetter healt h

De elo p ing ongoing communication betweenDe elo p ing ongoing communication between

patient and ph ysicianpatient and ph ysician


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Family p h ysicians areFamily p h ysicians arerelations h iprelations h ip oriented,oriented,

w h ic h ensuresw h ic h ensuresGood relations h ips with other ph ysicians andGood relations h ips with other ph ysicians andhealt h care pro iders .healt h care pro iders .

Better patient understanding of com p lexBetter patient understanding of com p lexmedical issues and im pro ed participation inmedical issues and im pro ed participation inthe care process .the care process .

Less ex pensi e and better healt hcareLess ex pensi e and better healt hcareexperience for patient .experience for patient .


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Family p h ysicians h ave a naturalFamily p h ysicians h ave a natural

command of complexity andcommand of complexity andThri e on managing com p lex medicalThri e on managing com p lex medicalproblemsproblems

Integrate all of t he medical and personalIntegrate all of t he medical and personalissues facing an indi idualissues facing an indi idual

Break down medical terms and com p lexBreak down medical terms and com p lexmedical issues to make it easier for patientsmedical issues to make it easier for patientsto understandto understand


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How are family p h ysicians trained?How are family p h ysicians trained?

3 years3 yearsore t han family medicine residenciesore t han family medicine residencies

C ommunityC ommunity--basedbased

edical sc hooledical sc hool--basedbasedilitaryilitary

Inner Inner--citycityUrbanUrbanS uburbanS uburbanRuralRuralInno ati e Training odelsInno ati e Training odels


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Family medicine residencyFamily medicine residency

clinical curriculumclinical curriculum A dult medicine A dult medicine C ritical care medicineC ritical care medicine

aternity careaternity care Gynecologic careGynecologic care

General surgeryGeneral surgery rt hopedicsrthopedicsEmergency careEmergency care C are of c hildrenC are of c hildren

S kin careS kin care Human be ha ior Human be ha ior

Womens healt hWomens healt h N ewborn careNewborn care

Continuity P atient CareContinuity P atient Care all 3 yearsall 3 yearsLife

Long

Learning


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Wh ats a typical week in familyWh ats a typical week in familymedicine?medicine?

Reas ns f isits t amily h ysicians

2

18.1

7.

9.

0.2

.1

0 5 10 15 20 25 0 5

Not R p or ted

Non-Illness ( pr eventive)

Pr e o r post su rg e r yollow u p

C r onic fla r e-u p

C r onic r outine pr oblem

Acute pr oblem

R e a s

n s

e centa e

S u ce: Nati nal Ambulat y Medical Ca e Su ey: 2005 Summa y. Nati nal Cente f Healt h Statistics


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A typical mont h of h ealt h careA typical mont h of h ealt h carein t h e United Statesin t h e United States

Source: N England Journal of Medicine 2001;344:2021Source: N England Journal of Medicine 2001;344:2021 25 25 ]:]:


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Hospital practice of familyHospital practice of familyp h ysiciansp h ysicians 20062006

83. % provide in patient care83. % provide in patient care8 .8 have hos pital admission privileges8 .8 have hos pital admission privileges

. % do routine B. % do routine B

.8% surgical.8% surgical--assistassist8 . % perform minor surgical procedures8 . % perform minor surgical procedures

38 .8% deli vered care in t he CC U38 .8% deli vered care in t he CC U. % deli vered care in t he IC U. % deli vered care in t he IC U

.9 % deli ver care in hos pital ER.9 % deli ver care in hos pital ER. % re ported deli vering newborn care. % re ported deli vering newborn care

SourceSource AAF P Facts About Family Medicine. Oct 2006 h ttp://www.aafp.org/facts.xmlAAF P Facts About Family Medicine. Oct 2006 h ttp://www.aafp.org/facts.xml


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Lifestyle of Family P h ysicians?Lifestyle of Family P h ysicians?

39. hours per week in direct patient care39. hours per week in direct patient care hours per week in patient related acti vitieshours per week in patient related acti vities

A vg. wks worked A vg. wks worked .9 weeks.9 weeksweeks for vacation/ CM Eweeks for vacation/ CM E

A vg. Income for : $ , A vg. Income for : $ ,

AAFP F acts A bout F amily M edicine . http://www.aaf p.org/facts .xml AAFP F acts A bout F amily M edicine . http://www.aaf p.org/facts .xml2 2 M erritt Hawkins & A ssoc . Re view of P hysician and C RN A RecruitingM erritt Hawkins & A ssoc . Re view of P hysician and C RN A RecruitingIncenti ves . ct . Incenti ves . ct .


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Are family p h ysicians in demand?Are family p h ysicians in demand?

TheThe Number OneNumber One most recruited s pecialty inmost recruited s pecialty in

The primary care s pecialty most in demandThe primary care s pecialty most in demand

3 % increase in recruitment of family ph ysicians in3 % increase in recruitment of family ph ysicians in

11 M erritt Hawkins & A ssoc . Re view of P hysician and C RN A Recruiting Incenti ves . ctM erritt Hawkins & A ssoc . Re view of P hysician and C RN A Recruiting Incenti ves . ctHawkins, J . Encouraging news about family ph ysician recruitment . Hawkins, J . Encouraging news about family ph ysician recruitment .

F amily P ractice M anagement . A pr; ( );F amily P ractice M anagement . A pr; ( ); --8 .8 .


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Wh at loan repayment options areWh at loan repayment options areavailable for family p h ysicians?available for family p h ysicians?


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Wh ats t h e future of familyWh ats t h e future of familymedicine?medicine?

Electronic healt h record (EHR)Electronic healt h record (EHR)

nline a pp ointmentsnline a pp ointments

WebWeb--based patient educationbased patient education

EE--visitsvisits


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Innovations in family medicineInnovations in family medicine

Grou p visitsGrou p visits

Team a pp roac h to careTeam a pp roac h to care

S ystematic a pp roac h to careS ystematic a pp roac h to care

C hronic disease managementC hronic disease management


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Future of family medicineFuture of family medicineM arket researc hM arket researc h

S ix task forcesS ix task forces

F amily medicines newF amily medicines newmodel of caremodel of care

P ersonal medical homeP ersonal medical home

C ontinuous relations hipC ontinuous relations hip

Basket of ser vicesBasket of ser vices


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More about family medicineMore about family medicine

F amily medicineF amily medicinede partmentde partment

F amily medicineF amily medicine

clerks hip director clerks hip director

Your sc hools FM IGYour sc hools FM IG

irtual FM IG atirtual FM IG atfmignet .aaf p.orgfmignet .aaf p.org

AAFP chapter AAFP chapter

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Student Fm Presentation 2007