Family Medicine Practitioners Research Articles

Family medicine and general practitioner supervisor wellbeing - a literature review.

Research examining General Practice (GP) supervisor wellbeing has often been conducted within the context of trainee wellbeing and educational outcomes. This review aimed to consolidate the current literature regarding the wellbeing of GP supervisors through a 'supervisor-wellbeing' lens. Literature review METHOD: The Embase, Ovid MEDLINE and Ovid PsycInfo databases were systematically searched from inception to December 2022. Original research studies were eligible if they explored any aspect of wellbeing or burnout (ie, construct conceptualisations, risk and protective factors, implications, or interventions) amongst GPs involved in educating GP trainees. Reporting quality of included studies was assessed using the QualSyst tools. Results from included studies were narratively synthesised. Data from 26 independent studies were reviewed. Burnout was generally conceptualised using the Leiter and Maslach model. Wellbeing was poorly defined in the literature, largely being conceptualised in personal psychological terms and, to a lesser extent, professional satisfaction. Risk and protective factors were identified and grouped as individual (eg, satisfaction with capacity to teach) and external (eg, autonomy, collegial relationships, resource availability) factors. GP supervisors' wellbeing appeared to affect their job performance and retention. This review identified only two studies evaluating interventions to support GP supervisors' wellbeing. The present review highlights a lack of conceptual clarity and research examining interventions for GP supervisor wellbeing. It provides guidance for future research designed to maximise the wellbeing of GP supervisors and support the wellbeing of trainees.

Factors Associated with Early and Periodic Screening, Diagnostic, and Treatment Services in a Medicaid Managed Care Pediatric Population

Abstract: Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services is a Medicaid benefit for children that addresses their health problems before they become advanced, debilitating, and expensive. We conducted a retrospective cross-sectional analysis of pediatric beneficiaries (newborn to younger than 21 years) enrolled in a Medicaid managed care organization to examine the factors associated with EPSDT screening services completion. We obtained 2018 administrative claims data for beneficiaries continuously enrolled for a minimum of 90 days (n=156,108). Completion of EPSDT screening services among our Medicaid managed care beneficiaries was low. Those having more emergency department visits and hospitalizations, having family medicine practitioners as primary care physicians, belonging to the racial/ethnic group Asian/Pacific Islander/Hawaiian/Alaskan Native/Native American, and 18 to younger than 21 years age group were less likely than others to complete EPSDT services. Our results provide information on segments of pediatric beneficiaries that can be targeted to increase EPSDT screening services completion.

A Nationwide Chronic Disease Management Solution via Clinical Decision Support Services: Software Development and Real-Life Implementation Report.

The increasing population of older adults has led to a rise in the demand for health care services, with chronic diseases being a major burden. Person-centered integrated care is required to address these challenges; hence, the Turkish Ministry of Health has initiated strategies to implement an integrated health care model for chronic disease management. We aim to present the design, development, nationwide implementation, and initial performance results of the national Disease Management Platform (DMP). This paper's objective is to present the design decisions taken and technical solutions provided to ensure successful nationwide implementation by addressing several challenges, including interoperability with existing IT systems, integration with clinical workflow, enabling transition of care, ease of use by health care professionals, scalability, high performance, and adaptability. The DMP is implemented as an integrated care solution that heavily uses clinical decision support services to coordinate effective screening and management of chronic diseases in adherence to evidence-based clinical guidelines and, hence, to increase the quality of health care delivery. The DMP is designed and implemented to be easily integrated with the existing regional and national health IT systems via conformance to international health IT standards, such as Health Level Seven Fast Healthcare Interoperability Resources. A repeatable cocreation strategy has been used to design and develop new disease modules to ensure extensibility while ensuring ease of use and seamless integration into the regular clinical workflow during patient encounters. The DMP is horizontally scalable in case of high load to ensure high performance. As of September 2023, the DMP has been used by 25,568 health professionals to perform 73,715,269 encounters for 16,058,904 unique citizens. It has been used to screen and monitor chronic diseases such as obesity, cardiovascular risk, diabetes, and hypertension, resulting in the diagnosis of 3,545,573 patients with obesity, 534,423 patients with high cardiovascular risk, 490,346 patients with diabetes, and 144,768 patients with hypertension. It has been demonstrated that the platform can scale horizontally and efficiently provides services to thousands of family medicine practitioners without performance problems. The system seamlessly interoperates with existing health IT solutions and runs as a part of the clinical workflow of physicians at the point of care. By automatically accessing and processing patient data from various sources to provide personalized care plan guidance, it maximizes the effect of evidence-based decision support services by seamless integration with point-of-care electronic health record systems. As the system is built on international code systems and standards, adaptation and deployment to additional regional and national settings become easily possible. The nationwide DMP as an integrated care solution has been operational since January 2020, coordinating effective screening and management of chronic diseases in adherence to evidence-based clinical guidelines.

Assessment of the knowledge and practice of Jordanian family medicine practitioners regarding vitamin B12 screening for type 2 diabetes mellitus patients on metformin

Assessment of the knowledge and practice of Jordanian family medicine practitioners regarding vitamin B12 screening for type 2 diabetes mellitus patients on metformin

Effects of extending residencies on the supply and quality of family medicine practitioners; difference-in-differences evidence from the implementation of mandatory family medicine residencies in Canada.

I examine the impacts of extending residency training programs on the supply and quality of physicians practicing primary care. I leverage mandated extended residency lengths for primary care practitioners that were rolled out over 20years in Canada on a province-by-province basis. I compare these primary care specialties to other specialties that did not change residency length (first difference) before and after the policy implementation (second difference) to assess how physician supply evolved in response. To examine quality outcomes, I use a set of scraped data and repeat this difference-in-differences identification strategy for complaints resulting in censure against physicians in Ontario. I find declines in the number of primary care providers by 5% for up to 9years after the policy change. These changes are particularly pronounced in new graduates and younger physicians, suggesting that the policy change dissuaded these physicians from entering primary care residencies. I find no impacts on quality of physicians as measured by public censure of physicians. This suggests that extending primary care training caused declines in physician supply without improvement in the quality of these physicians. This has implications for current plans to extend residency training programs.

Attitudes and Practices towards the use of technology‐screening tools, diagnosis, and management of cognitive impairment in primary care

AbstractBackgroundPrevious studies in the Cuban population suggest that Alzheimer’s Disease and related dementias (ADRD) are under‐diagnosed at primary care relative to population estimates. Recent interventions aimed to introduce the use of technology based cognitive assessments have been validated for primary care (e.g., Brain Health Assessment).However, the implementation of newly develop tools depends on the Primary care providers’ (PCPs) barrier and attitudes toward the diagnosis and management of patients with ADRD at a primary care level. Here we aimed to assess PCPs’ attitudes towards ADRD diagnosis, and the use of technology based cognitive assessments.Method84 PCPs were randomly selected form 10 primary care clinics. Sample size include a wide range of PCPs, including: family medicine (n = 54), neurologist (n = 2), psychiatrists(n = 13), psychologists(n = 10), clinicians (n = 3) and geriatricians (n = 2)). A questionnaire on Dementia assessment and management in primary care settings was administered to the participants. Descriptive statistics were employed for summarizing the data. Kruskal Wallis association test was utilized for determining associations between provider characteristics and outcomes.ResultsMost participants were female (n = 64, 76.2%), over 50 years old (n = 36, 52.9%) and family medicine practitioners (64.3%). The average number of patients consulted per month by PCPs were 250 (CI95% 250‐367) and over 60% of them were 55 years or older. Most of the PCPs (n = 63, 75.0%) will not refer patients with suspected ADRD if they had the training and instruments and technologies for the diagnosis at a primary care level. Lack of time (n = 59, 70.2%) and lack of confidence in their abilities (n = 68, 81.0%) were the most cited barriers for the diagnosis and management of ADRD . Around 80.0% of the interviewed practitioners considered the use of technology based cognitive assessments as important or very important tool for ADRD diagnosis. The positive attitudes of the PCPs for using technologies were correlated with the municipalities where they work (p = 0.01) and the continuous professional development of the PCPs (p = 0.03).ConclusionThere are still barriers for the diagnosis of ADRD at a primary care level. Though PCPs are willing to implement technology based cognitive assessments in their daily practice, addressing existing barriers is key for success

Common adolescent mental health disorders seen in Family Medicine Clinics in Ghana and Nigeria.

Mental health disorders among adolescents is on the rise globally. Patients seldom present to mental health physicians, for fear of stigmatization, and due to the dearth of mental health physicians. They are mostly picked during consultations with Family Physicians. This study seeks to identify the common mental health disorders seen by family Physicians in Family Medicine Clinics in Nigeria and Ghana. A descriptive cross-sectional study involving 302 Physicians practicing in Family Medicine Clinics in Nigeria and Ghana, who were randomly selected for the study. Data were collected using self-administered semi-structured questionnaire, and were entered into excel spreadsheet before analysing with IBM-SPSS version 22. Descriptive statistics using frequencies and percentages was used to describe variables. Of the 302 Physicians recruited for the study, only 233 completed the study, in which 168 (72.1%) practiced in Nigeria and 65 (27.9%) in Ghana. They were mostly in urban communities (77.3%) and tertiary health facilities (65.2%). Over 90% of Family Medicine practitioners attended to adolescents with mental health issues with over 70% of them seeing at least 2 adolescents with mental health issues every year. The burden of mental health disorder was 16% and the common mental health disorders seen were depression (59.2%), Bipolar Affective Disorder (55.8%), Epilepsy (51.9%) and Substance Abuse Disorder (44.2%). Family Physicians in Nigeria and Ghana attend to a good number of adolescents with mental health disorders in their clinics. There is the need for Family Physicians to have specialized training and retraining to be able to recognize and treat adolescent mental health disorders. This will help to reduce stigmatization and improve the management of the disease thus, reducing the burden.

Adequancy of treatment with canaglifozin alter alerts pharmacovigilance in the health management area

ObjectiveTo analyze the impact of a strategy on the suitability of canaglizozin, and its level of acceptance, after issuing recommendations based on drug surveillance alerts issued by the Spanish Medicines and Medical Devices Agency (AEMPS). DesignA prospective intervention from may 2016 to october 2016. LocationSouth Seville Health Management Area. ParticipantsPatients with active canagliflozin prescription. InterventionsThe study was conducted in three phases, the first one linked to the issuance of the safety information note on the canaglifozin by the AEMPS, the obtaining of the patient lists and the recommendations of the adequacy in the sending of letters. A second phase where the medical professional performed the actions and a final phase in which the degree of acceptance of the recommendations made by the Pharmacy Service is evaluated. Main measurementsSuitability of canaglizozin treatment and the level of acceptance by physicians. ResultsA total of 61 patients at baseline were included in treatment canagliflozin. Of the total number of patients referred to, some type of intervention was performed by the family and community medicine doctor after the pharmaceutical intervention (PI), by means of letters (n = 30), 56.7% were monitored, 33.3% were discontinued and 10.0% were closely monitored ConclusionsInterventions aimed at reviewing patients on canagliptin, based on pharmacovigilance alerts, have been effective, with a high degree of acceptance by the family and community medicine practitioner.

Uzman Hekimlerin Bağlanma Stilleri ve Bağlanma Stillerinin Uzmanlık Dalıyla İlişkisi

Objective: The aim of this study is to evaluate the attachment styles of specialist physicians and to examine the differences in attachment styles according to their specialty and whether they are placed in their first preference in the medical specialty exam (TUS).
 Method: A total of 92 physicians were included in the study. Individual information collection forms and the Relationship Scales Questionnaire (RSQ) were administered to all participants. Participants were asked about their gender, their specialization field, and whether their current specialization field was their first choice in the Medical Specialization Exam (TUS). Specialization fields were divided into 4 groups: surgical specialties, internal medicine specialties, basic medical sciences, and family medicine specialization.
 Results: Among all participants, 14.1% exhibited secure attachment, 57.6% displayed fearful attachment, 32.6% demonstrated preoccupied attachment, and 3.3% had dismissive attachment. There was no significant difference in attachment styles based on the participants' genders. There was no significant difference in attachment styles based on whether they entered their first choice in the Medical Specialization Exam (TUS). There was no significant difference in attachment styles based on the specialization fields in which the participants received their education.
 Conclusion: Among expert physicians, anxious attachment was the most common attachment style. Although there was no statistically significant difference in attachment styles based on physicians' specialization fields, family medicine and internal medicine practitioners exhibited a higher rate of secure attachment compared to those in the basic medical and surgical sciences. Determination of other possible motivational factors as well as attachment styles could provide guidance and insight to the physician in this choice that will affect her/his whole life

The Factors Affecting the Level of Job Satisfaction of Family Physicians and their Relationship with Professional Self-Esteem

Objective: The study aimed to investigate the relationship between job satisfaction and professional self-esteem levels of family medicine practitioners working in Family Health Center. 
 Materials and Methods: Between April 2021 and April 2022, 128 family physicians who volunteered from 155 family physicians working in family health centres in Giresun province were included in the study. The socio-demographic descriptive form, the Minnesota Job Satisfaction and Occupational Self-Esteem Scales were administered face-to-face and online (via WhatsApp groups and e-mail communities). 
 Results: There was no significant relationship between job satisfaction and its sub-dimensions with age, gender, marital status, specialisation status, physical conditions of the Family Health Center, total years of practice and years of training in family medicine (p>0.05). The mean level of occupational self-esteem was 112.48. It was found to be significantly positively correlated with age, total years of practice, years of family medicine practice and average number of patients seen (p=0.05, p=0.004, p=0.004, p=0.004, p=0.009, respectively). 
 Conclusion: Professional self-esteem levels increase as professional age, total years of profession, and total years of working in family medicine increase.

The Role of Physicians' Factors in Underdiagnosis of Celiac Disease in the Eastern Province of Saudi Arabia.

Background Celiac disease is an autoimmune disorder triggered by gluten and related prolamines, which can cause a variety of symptoms and complications if left untreated. Despite being a common lifelong disorder, it often goes undiagnosed for a long time, leading to negative impacts on patients' health and quality of life. The diagnosis of celiac disease requires the presence of celiac-specific autoantibodies and distinctive histological changes in the small intestinal mucosa. Lack of disease knowledge among healthcare professionals and patients' adherence to gluten-free diets may contribute to diagnostic delays. Objectives This study aims to assess the reasons for celiac disease underdiagnosis and identify the functional deficiencies of healthcare professionals in the diagnosis and treatment of celiac disease, particularly in the Saudi population. Materials and methods A cross-sectional, questionnaire-based study was conducted among physicians in the Eastern Province of Saudi Arabia during the year 2023, between May and July. Participants were asked to complete an online self-administered questionnaire that included questions about their demographic characteristics, professional experience, and knowledge and attitudes toward celiac disease. The study recruited gastroenterologists, gastroenterology fellows, internal and family medicine specialists, residents, and general practitioners working in private or public health centers in various cities of the Eastern Province. Results The data were collected from 180 physicians who fulfilled the inclusion criteria of the study, with most participants aged under 30 years and predominantly male. Family medicine and general practitioners were the most represented specialties. While 49.4% of physicians knew that adult celiac disease was rare, only 19.4% frequently recommended celiac disease serology to their patients. In terms of risk, most physicians knew that adult celiac disease was a moderately severe and disabling disease, but only 24.4% thought that the cancer risk in patients with celiac disease was moderate. About 75.6% of physicians had an overall poor knowledge level regarding celiac disease, with gastroenterologists and internal medicine specialists demonstrating better knowledge compared to other specialties (P = 0.001). Conclusion The study found that a majority of physicians in the Eastern Province of Saudi Arabia had poor knowledge about celiac disease. This lack of knowledge could have implications for patient care, as it could lead to delays in diagnosis, inadequate treatment, and increased risk of complications.

Clinico-epidemiological characteristics of the biliary samples and their antibiotic susceptibility pattern at a teaching hospital in Northern India.

Bile is deemed a sterile fluid, with the presence of clinical conditions like cholelithiasis, cholecystitis, previous biliary interventions, biliary strictures, and so on, leading to bile stasis, and increases the chances of bacteriobilia. In this study, we recognize the bacterial spectrum of microorganisms isolated from bile samples, diagnostic parameters, and antibiotic sensitivity patterns. A retrospective observational study was carried out by compiling data from the hospital information system of a tertiary care center from 2021 to 2022 to evaluate biliary infections in patients who underwent surgical procedures related to the biliary tract and associated organs. A total of 234 patients' bile samples were included in our study. The mean age of patients was 48.04 ± 14.74 years, with more patients below the age of 65 years among those with infected bile samples. One hundred and sixty-three (163/234, 69.66%) patients infected by 209 pathogenic microorganisms were recognized. The most common microorganism isolated was Escherichia coli (83/209, 39.71%), followed by Pseudomonas aeruginosa (37/209, 17.7%). Acinetobacter baumannii and Klebsiella pneumoniae isolate owed to more than 90% penicillin, extended-spectrum beta-lactamase, carbapenem, and fluoroquinolone resistance among all isolates. Length of hospital stay, malignant obstruction, and chronic kidney disease were identified as statistically significant risk factors that lead to the isolation of multi-drug-resistant isolates from bile culture. We recognized the spectrum of pathogens causing biliary tract infections at our center along with the antibiotic resistance pattern to guide and facilitate prompt and appropriate treatment by primary health care professionals and family medicine practitioners.

Clinical presentations and microbiological analysis of cerebrospinal fluid samples in cases of suspected bacterial meningitis patients attending a 1600 bedded teaching hospital from 2019 to 2022: A retrospective study.

Meningitis can be attributed to bacterial, fungal, or viral agents. In this study, we demonstrate the common bacterial agents causing meningitis along with their antibiotics susceptibility pattern in patients of all age groups. This retrospective, observational study was carried out in the Department of Microbiology with cerebrospinal fluid (CSF) samples collected from November 2019 to May 2022. We collected 1986 nonrepeat CSF samples from clinically suspected patients of bacterial meningitis, and clinical information about the patients was extracted from the hospital information system. Out of the 1986 CSF samples included in our study, 150 (7.55%) were found to be positive on bacterial culture. Most of our patients were in the age group of 0-20 years. Common clinical manifestations observed in our patients were: high-grade fever, 87 patients (58%); severe headache, 126 patients (84%); neck rigidity, 47 patients (31.3%); altered mental status, 76 patients (50.7%) and photophobia, 83 patients (55.3%). The most commonly isolated bacteria was Acinetobacter species (30%). The mean length of hospitalization (37.76 ± 25.30), the mean total cell count, high levels of protein (mg/dl) and low levels of glucose (mg/dl) of CSF were statistically significant in meningitis caused by multidrug-resistant bacteria. We recognized the spectrum of pathogens causing meningitis at our center along with the antibiotic resistance pattern to guide and facilitate early treatment by primary health care professionals and family medicine practitioners.

Family medicine residents’ perspectives on different teaching modalities used throughout their training

ABSTRACT Background: New teaching modalities have emerged throughout the years to help enhance residency training programs. Studies have shown that when establishing a new teaching modality, it is crucial to consider the trainee’s perception and feedback as trainee-centered teaching techniques aim to enhance the students’ motivations and problem-solving skills. The aim of this study is to discover residents’ perceptions of different teaching modalities used through their training programs and to recognize which teaching modality is preferable to residents among the family medicine residents in Riyadh, Saudi Arabia. Methodology: A cross-sectional study was conducted between April 2021 and April 2022 that included all family medicine residents in the Saudi Board Family Medicine Training Program at Prince Sultan Military Medical City (PSMMC) in Riyadh, Kingdom of Saudi Arabia. An online questionnaire included two main parts. The first part collected demographic information. The second part concerned residents’ opinions regarding different teaching modalities used throughout their training and factors leading to better learning outcomes. Results: The survey was completed by 60 family medicine residents. Half of the respondents perceived weekly academic day activities [WADA] as the most important teaching style (53.3%), followed by self-directed learning [SDL] (40%), while learning management system [LMS] was not ranked as the top choice by any of the respondents. Conclusion: These findings can be applied to the improvement of family medicine training programs. Understanding the perceptions of different teaching modalities can help enhance training programs to help future family medicine practitioners.

Identifying the Challenges of Child Abuse Detection Among Emergency, Pediatrics, and Family Medicine Practitioners in Saudi Arabia.

Child abuse is a significant issue across many countries. Despite the situation's innate understanding, many children are not reported to authorities and continue to experience abuse, sometimes even death. Healthcare professionals must be alert for abuse in any child who appears with injuries that are out of the ordinary because it is easy for indicators of child abuse to go unnoticed in a busy emergency department. The current study aims to evaluate and detect the challenges in diagnosing and reporting cases of child abuse among healthcare practitioners in emergency, pediatrics, and family medicine. A self-administered online disseminated questionnaire was used for data collection during the period fromOctober 1 to December 30, 2022. A cross-sectional study was conducted on emergency, pediatrics, and family medicine healthcare practitioners working in hospitals in healthcare centers in Riyadh, Saudi Arabia. All data were collected, tabulated, and statistically analyzed using SPSS 23.0 for (IBM Corp., Armonk, NY) Windows. The study sample constituted 200 physicians working in the front lines of healthcare like emergency, pediatrics, and family medicine primary care services,50.5% were males and 49.5% were females. 36.5% of participants were 31-39 years old. 42% were family medicine physicians, 36.5% were pediatricians, and 21.5% were emergency medicine. About 43% of participants attended an educational workshop on child abuse. Nineteen percent of participants are very familiar with the diagnosis of child abuse and 36% of participants reported one to three cases of child abuse in the emergency department in the last year, 5% reported four to six cases and 56.5% reported none. Forty-seven percent of participants reported diagnosing one to five cases of child abuse throughout their whole career, 13% reported 11-15 cases, 6.5% reported six to 10 cases and 28.5% reported none. Causes of underdiagnosis of child abuse by healthcare providers were reported as 63% inexperience, 59% inadequate time for physical examination, 59% lack of diagnosis protocol, 51% lack of confidence in communicating with parents, 36% physicians' cultural background, and 38% lack of confidence in the diagnosis. 93.5% of participants think that healthcare practices need further education for child abuse. In conclusion, physicians in Saudi Arabia who participated in the study had good knowledge to diagnose a case of child abuse. Inexperience, inadequate time for physical examination, lack of diagnosis protocol, lack of confidence in communicating with parents, and physicians' cultural background were the main identified challenges for diagnosing child abuse. Familiarity with cases of child abuse was significantly associated with physicians' age, specialty, and level of training.

JCL Roundtable: From Gen Med to Clinical Lipidology.

The prevalence of lipid-related risk for atherosclerotic cardiovascular disease surpasses half the population as individuals age, and thus generalists and primary care providers manage by far the bulk of treatment of lipid disorders. It should come as no surprise that many individuals who practice clinical lipidology, focusing on the care of patients with resistant or perplexing lipid disorders, come from a background of general or primary care medicine. Among 429 providers responding to a survey of National Lipid Association (NLA) members in 2010, 50% were internal medicine or family medicine practitioners, 32% cardiologists, 11% endocrinologists, and 7% with a variety of other specialty training. This JCL Roundtable brings together 3 NLA physician leaders who came from primary care. We discuss their career pathways, their blend of practice, teaching, research, and administration, and the settings in which they carry out the lipidology mission.

Community Health Worker programmes’ integration into national health systems: Scoping review

The African Journal of Primary Health & Family Medicine welcomes submissions that encourage scholarly exchange between family medicine and primary health care researchers and practitioners across Africa and the developing world, whilst providing a contextual and holistic view of family medicine as practiced across the continent.

Training needs of professional nurses in primary health care in the Cape Metropole, South Africa

The African Journal of Primary Health & Family Medicine welcomes submissions that encourage scholarly exchange between family medicine and primary health care researchers and practitioners across Africa and the developing world, whilst providing a contextual and holistic view of family medicine as practiced across the continent.

Physician Perspectives on Vaccination in Patients With Autoimmune Inflammatory Rheumatic Diseases: An International Survey.

To evaluate the perspective of physicians who care for patients with autoimmune inflammatory rheumatic disease (AIIRD) toward vaccination. Physicians who care for patients with AIIRD were invited to participate in an online survey regarding their vaccination perspectives in adult patients with AIIRD. Survey responses of 370 physicians from Asia (41.1%), North America (41.6%), Europe (13.8%), and other countries (3.5%) were analyzed. Participants stated that rheumatologists (58.2%) should be primarily responsible for vaccination coverage, followed by general internists (19.3%) and family medicine practitioners (12.8%). Additionally, 96.7% of participants considered vaccination very important (≥ 4/5 rating) for patients with AIIRD. Despite these sentiments, only one-third (37%) reported vaccinating the majority (≥ 60%) of their patients. Physicians who care for patients with AIIRD agree that vaccines are effective and safe in patients with AIIRD. Unfortunately, they often do not ensure that their patients are adequately vaccinated. Further studies are needed to investigate how to improve vaccination coverage for this high-risk patient population.

Building the foundation for universal healthcare: Academic family medicine's ability to train family medicine practitioners to meet the needs of their community across the globe.

BackgroundThe Declaration of Astana marked a revived global interest in investing in primary care as a means to achieve universal healthcare. Family medicine clinicians are uniquely trained to provide high-quality, comprehensive primary care throughout the lifespan. Yet little focus has been placed on understanding the needs of family medicine training programs.AimThis study aims to assess broad patterns of strengths and resource challenges faced by academic programs that train family medicine clinicians.MethodsAn anonymous online survey was sent to family medicine faculty using World Organization of Family Doctors (WONCA) listservs.ResultsTwenty-nine representatives of academic family medicine programs from around the globe answered the survey. Respondents cited funding for the program and/or individual trainees as one of either their greatest resources or greatest limitations. Frequently available resources included quality and quantity of faculty and reliable clinical training sites. Frequently noted limitations included recruitment capacity and social capital. Over half of respondents reported their program had at some point faced a disruption or gap in its ability to recruit or train, most often because of loss of government recognition. Reflecting on these patterns, respondents expressed strong interest in partnerships focusing on faculty development and research collaboration.Lessons learntThis study provides a better understanding of the challenges family medicine training programs face and how to contribute to their sustainability and growth, particularly in terms of areas for investment, opportunities for government policy and action and areas of collaboration.Keywordsfamily medicine; primary care; medical education; global health; community medicine.