In this study of family physicians taking ABFM examinations, graduating family medicine residents reported an intention to provide a broader scope of practice than that reported by current practitioners. This pattern suggests that these differences are not generational, but whether they are due to limited practice support, employer constraints, or other causes remains to be determined.

Objective Establish a current cross-sectional national picture of IUD and implant provision by U.S. family physicians, and ascertain individual, clinical site, and scope of practice level associations with provision. Study Design Secondary analysis of data from 2,329 family physicians recertifying with the American Board of Family Medicine in 2014. Results Overall, 19.7% of respondents regularly inserted IUDs and 11.3% regularly inserted and/or removed implants. Family physicians provided these services in a wide range of clinical settings. In bivariate analysis almost all of the individual, clinical site and scope of practice characteristics we examined were associated with provision of both methods. In multivariate analysis the scope of practice characteristics showed the strongest association with both IUD and implant provision. For IUDs this included providing prenatal care with [adjusted odds ratio (aOR) 3.26, 95% confidence interval (95% CI) 1.93-5.49] or without (aOR 3.38, 95% CI 1.88-6.06) delivery, performance of endometrial biopsies (aOR 16.51, 95% CI 11.97-22.79), and implant insertion and removal (aOR 8.78, 95% CI 5.79-13.33). For implants it was: providing prenatal care and delivery (aOR 1.77, 95% CI 1.15-2.74), office skin procedures (aOR 3.07, 95% CI 1.47-6.42), endometrial biopsies (aOR 3.67, 95% CI 2.41-5.59) and IUD insertion (aOR 8.58, 95% CI 5.70 -12.91). Conclusions While a minority of family physicians regularly provided IUDs and/or implants, those who provided did so in a broad range of outpatient settings. Individual and clinical site characteristics were not largely predictive of provision. This connotes potential for family physicians to increase IUD and implant access in a variety of settings. Provision of both methods was strongly associated with scope of practice variables including performance of certain office procedures as well as prenatal and/or obstetrical care.

In addition to payments for services rendered to individual patients, primary care physicians will increasingly be paid for their ability to achieve goals across the body of patients most closely associated with them: their "panel.

These findings suggest that QI completed through the PPMs may assist family physicians in improving the care they provide. Furthermore, ratings by the number of PPMs completed suggest that repeated exposure to QI efforts produce continued relevance and usefulness, even when changes in practice decline.