Burnout affects about half of family physicians (FPs). Minimal research exists which examines the impact of urban and rural practice settings on FP burnout. In this study, we examined whether rural practice is associated with FP burnout.Methods: Data from the 2017 and 2018 American Board of Family Medicine Family Medicine Certification examination registration questionnaire were used. We limited our sample to FPs in continuity care in the United States. The questionnaire is a mandatory component of registration, resulting in a 100% response rate. Burnout was measured via 2 questions validated against the Maslach Burnout Inventory. We used logistic regression to determine associations between burnout and rural location, controlling for practice and personal characteristics.Findings: Of the FPs surveyed, 2,740 met our inclusion criteria. Rural FPs were older, more likely to be male, and had a broader scope of practice than urban FPs. Rural FPs had a nonsignificantly higher burnout rate than urban FPs (45.1% vs 43.0%). Burnout was more common in younger and female FPs. We found no rural/urban differences between job satisfaction, practice environment, workload, and job stress; however, all of these characteristics were associated with burnout. In adjusted analyses, rural location was not associated with burnout (odds ratio = 1.15, 95% CI: 0.87-1.52). Conclusion:In a large national sample, we found no difference in burnout between rural and urban FPs. This suggests there is nothing unique about rural practice that predisposes to burnout and that a common pathway to reduce burnout may exist.
Of family physicians who perform cesarean sections, more than half do so in rural communities and 38.6% provide cesarean sections in counties without any obstetrician/gynecologists. As policymakers in the United States struggle with a widening landscape of 'obstetrical deserts,' efforts to adequately train a family physician workforce prepared to provide cesarean sections could help maintain access to local obstetric services in rural communities and reduce perinatal morbidity and mortality.
Background and Objectives: Family physicians (FPs) are well positioned to increase abortion access given their broad scope and diverse geographic practice regions. Previously published studies focus on physicians who received formal abortion training but do not include the full landscape of FPs performing abortions in the United States. This secondary data analysis presents a unique opportunity to examine characteristics of early-career FPs who provide abortions, including practice locations and if they received abortion training during residency. Methods: We analyzed data from the 2016-2018 Family Medicine National Graduate Survey to generate descriptive statistics about respondents who report providing pregnancy termination, uterine aspiration/dilation and curettage, or both. We evaluated associations between physician and/or practice characteristics and providing pregnancy termination using bivariate statistics. Results: Of the 6,319 survey respondents, 3% reported providing pregnancy termination. Nearly three-quarters of this subset reported graduating residency feeling prepared to provide pregnancy termination. Most respondents completed residency in the West or Northeast US geographic regions, and 3 years later were practicing in the West or South regions. Additional characteristics associated with providing pregnancy termination include female gender, providing continuity care, and practicing in either an academic medical center or a federally qualified health center. Conclusions: FPs are well positioned to address gaps in abortion access, and those who provide pregnancy termination practice in various US geographic regions. This is the first discussion of its kind about the scope of family physicians providing abortion care. Future research should continue to characterize FPs who provide abortions to determine where they train and practice and what type of abortions they provide.
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