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Wednesday Oct 16, 2013

Residents Can Attest to Demand for FPs

I recently served as a panelist during National Primary Care Week activities at my alma mater, Marshall University's Joan C. Edwards School of Medicine. During our session, one of the medical school students asked me how family medicine might change in light of more mid-levels providing primary care. Specifically, the student wanted to know if demand for family physicians might fizzle.

My response?

Absolutely not.

Family physicians are in demand more than any other specialty and have been for seven years running, according to Merritt Hawkins. The health care search and consulting firm said in a report last month that the growing demand for family physicians stems from the need for employed FPs in hospitals and health care systems.

The number of medical students choosing family medicine increased for the fourth straight year in the 2013 National Resident Matching Programand more U.S. seniors matched to family medicine than in any year since 2002.

Despite those positive signs, the supply of family physicians is nowhere near balanced with the demand. Researchers estimate that the country needs 52,000 more primary care physicians by 2025.

The fact that family physicians are in demand should come as no surprise to family medicine residents. I receive solicitations daily from recruiters, despite the fact that I'm not looking for a job. I signed a contract more than a year ago for a position that will start in August 2014. Most residents don't sign that early, but I found exactly the kind of practice I wanted to join. The federally qualified health center is a patient-centered medical home with a physician friendly electronic health record. Its reimbursement model includes per-member, per-month fees.

The practice is continually pursuing, and receiving, innovation grants and trying new things, so I'm happy with my choice. I'm not circulating my resume. I don't even have a LinkedIn account. And yet, the calls, e-mails and snail mail keep coming at home and at work every day.

One of my fellow third-year residents -- who is looking for a family medicine job -- said she receives more than a dozen e-mails a day from recruiters.

So what did I tell that student during our panel discussion?

I said that nurse practitioners often specialize, so they can't necessarily improve access to primary care in areas of need.

I said family physicians should work to appropriately incorporate mid-levels into our practices because they can play a vital role on our health care teams.

And, I pointed out that many patients prefer to see a physician, and some will switch practices if they don't think they have proper access to their doctor.

We are in demand by patients and employers, and that isn't likely to change.

Kimberly Becher, M.D., is the resident member of the AAFP Board of Directors.


Posted by Gloria Zibilich on October 17, 2013 at 05:54 AM CDT #

As a previously hospital employed family physician in a rural outpatient practice I personally felt the negative impact that midlevels can have on the job security of a family physician. The hospital expanded our services by adding another midlevel to our practice. When hard economic times hit the hospital's revenue, many cuts were made. My contract was terminated due to "economic reasons". The newly hired PA continues to be employed. Opportunities for employed outpatient family docs are abundant throughout the nation, but not in this rural area. However, I was not prepared to move for personal reasons. I reluctantly jumped from my beloved family practice ship into the unknown waters of urgent care. It feels more like "just a job " now than the dedicated vocation of family practice in which I thrived. My advise to residents seeking an employed position is to look long and hard at the economic stability of the practice area. We need family physicians in rural areas and we need the support of our hospitals.

Posted by Gloria Zibilich on October 17, 2013 at 06:27 AM CDT #

If Family Medicine wants to insure being a part of the future of health care delivery in this country, recognizing the importance of the life cycle of a family physician is key. in years past, there was both a formal and informal mentoring process to guide family physicians through the milestones of their careers. The consternation on the part of young students interested in family medicine and young family resident physicians transitioning out of training is a direct result of not having seasoned role models readily available to them during their formal education. Part of my responsibilities as an employed physician in a large health system is to mentor our young physicians as they transition out of residency training into practice. Being available to guide and direct is what will help our specialty stay strong and vital. helping young physicians resist the urges of volume( the traditional productivity model) over value early on in one's transition is key to developing a successful practice today. Honing the skills of a well-rounded family physician requires the patience of experience and reason. Family medicine is alive and well but will only remain so with everyone taking responsibility for its future.

Posted by Dale Block on October 17, 2013 at 07:28 AM CDT #

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