Abstract
Family Medicine (FM) is the care of unselected patients with undifferentiated problems in the settings where people need care in our communities. It is intellectually challenging, providing breadth and depth unparalleled in other areas of medical practice. In one survey only 19% of Israeli students reported being interested in FM. Students interested in FM had greater interest in bedside and direct long-term patient care. Students not planning FM residency training had preconceived notions that the discipline had lower academic opportunities and prestige. What can be done to increase student interest in careers in FM?This commentary includes perspectives of family practice leaders from several countries:The problem isn’t the students it is the scope of practice and expectations both of which can and should change if FM in Israel wants to stay viable. The scope of FM should be broadened to include more procedures and new technologies. This may also increase the earning potential of Family Practitioners (FPs). Payment policy and credentialing barriers should be change to expand scope of practice and allow FPs to practice at the full extent of their training.FM should offer clear professional horizon with potential for many sub-specialties and areas of focus. The Israeli HMOs, the Ministry of Health and the Israeli Association of FM should invest heavily in building academic departments of FM and promoting research. This will enhance the image of FM in the eyes of the students, the profession and the public.The clinical work environment should be improved by reducing bureaucratic assignments, such as issuing certifications, dealing with quality measurements and renewing chronic prescriptions. Much of this work can be done by nurse practitioners (NPs) working as part of an FP-led team. These NPs can also take care of patients with limited complaints to make the work of the FP more challenging and attractive.Training must include opportunities to develop longitudinal relationships with patients and families across problems and over time. It is these relationships that add value to the process of care, improve patient outcomes and provide meaning to sustain clinical careers that meet the needs of patients and communities.
Highlights
Medicine (FM) is the care of unselected patients with undifferentiated problems in the settings where people need care in our communities
The article by Naimir, et al in a recent issue of Israel Journal of Health Policy Research identified a major problem of the Israeli medical care system: Why do Israeli medical school graduates rarely choose careers as Family Physicians (FP)? In their survey, only 19% of students reported being interested in Family Medicine (FM)
Students felt FM provided limited ability for professional growth and high income. They felt the clinical work environment of FM is less competitive compared to the hospital, but lacked the teamwork that existed on hospital wards
Summary
In training, creating primary care leadership and research tracks may help counter this perception (https://www.hopkinsmedicine.org/office-of-johnshopkins-physicians/best-practice-news/primarycare-leadership-track-rolls-out, https:// medschool.duke.edu/education/degree-programsandadmissions/primary-care-leadership-track), and help FPs to grow as leaders in medical education and research. Growth of national practice-based research networks to capture the power of primary care practices in the national research enterprise is critical to growing awareness of develop certificate programs or fellowships in med-ed/primary care research
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