Preparing the Personal Physician for Practice: Changing Family Medicine Residency Training to Enable New Model Practice

Abstract

After two years of intensive study, in 2004 the Future of Family Medicine report concluded that the current U.S. health care system is inadequate and unsustainable, and called for changes within the specialty of family medicine to ensure the future health of the American public. With guidance and encouragement from many disciplines and health experts, a set of 10 recommendations was established to accomplish a transformative change in how family physicians serve their patients and how the essential function of primary care is achieved. From these recommendations came a period of innovation and experimentation in the training of family physicians, entitled Preparing the Personal Physician for Practice (P4). The P4 project is a carefully designed and evaluated initiative led by the American Board of Family Medicine and the Association of Family Medicine Residency Directors and administered by TransforMED, a practice redesign initiative of the American Academy of Family Physicians. Fourteen family medicine programs were chosen to participate and will put their innovations into practice from 2007 to 2012, during which time regular evaluation will be conducted. The purpose of P4 is to learn how to improve the graduate medical education of family physicians such that they are prepared to be outstanding personal physicians and to work in the new models of practice now emerging. The innovations tested by P4 residencies are expected to inspire substantial changes in the content, structure, and locations of training of family physicians and to guide future revisions in accreditation and certification requirements.

Maternity Care Services Provided by Family Physicians in Rural Hospitals

“…A report from the Pacific Northwest found that only 5% of family medicine faculty had cesarean delivery privileges. 14 Recent experiments in family medicine residency education-the P4 project 24,25 and the Accreditation Council for Graduate Medical Education Length of Training Pilot 26 -may shed more light on the connection between educational approaches and the provision of advanced maternity care services by graduates of these programs. Cesarean deliveries may be a particularly important component of extended training options; previous research has found a correlation between training in this procedure and its provision in rural practice.…”

What Can Data Tell Us About the Quality and Relevance of Current Pediatric Residency Education?

“…3,60 In this endeavor, we can profit from the experiences of internal medicine and family medicine, because both fields are going through a similar methodology to achieve improvements in their residency training programs. [61][62][63][64][65] It is our hope that creative approaches fostered under this process will enhance learning, improve patient and family outcomes, and lead to more efficient, effective pediatric care.…”

The Patient-Centered Medical Home: Preparation of the Workforce, More Questions than Answers

“…[13][14][15] The National Demonstration Project, launched by the American Academy of Family Physicians in 2006 in an effort to assess the comprehensive PCMH model and findings related to transformation process requirements, reported in 2010 that this evolution was a complex process requiring motivated and engaged practice members. Over time, this process should continue to emphasize core attributes of collaborative care within primary care and attention to mental and public health.…”