Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM On Twitter
  • JABFM On YouTube
  • JABFM On Facebook
LetterCorrespondence

Re: Wide Gap between Preparation and Scope of Practice of Early Career Family Physicians

John J. Frey
The Journal of the American Board of Family Medicine September 2018, 31 (5) 829; DOI: https://doi.org/10.3122/jabfm.2018.05.180142
John J. Frey III
University of Wisconsin-Madison, Santa Fe, NM
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • References
  • Info & Metrics
  • PDF
Loading

To the Editor: Peterson et al.1 have published a stimulating piece that leaves the reader wanting more analysis, which will probably show up in future articles. For all the years since residency education began, a family medicine residency graduate faces a “buyers' market” relative to job opportunities that match one's desired practice. With appropriate guidance from teachers and mentors, residents should be able to clearly write down the values that are important to them, the type of community in which they would hope to practice, and the nature of the patients for whom they would like to care. I have a letter that I wrote in the fall of 1972 with those items and have referred to it as my career has gone along.

This report in the journal raises the issue of the early differentiation of residents in their desired scope of practice. Instead of a “generic stem cell” graduate, we have seen an increase in early choice making, almost immediately after the match has happened. One of the purposes of residency education is to expose residents to patients and communities and practice styles of colleagues that will influence their thinking about future choices. Deciding too early risks closing off learning.

If, however, the problem is, in part, corporate medicine in large cities deciding that fragmented care is what it wants to deliver, those systems should be confronted with the analyses and data that show that family doctors can and will provide comprehensive and integrated care at lower cost and higher quality. In the end, if large systems cannot figure out how to let family doctors “practice at the top of their degree,” then graduates can walk away, organize efforts to demand changes in their organization, or find another health system that will. Like unions in the early 20th century that demanded working conditions that met their needs, family doctors can collectively confront organizations that will not let us practice in the ways we are trained. But that discussion needs to happen among family doctors of all ages and generations. Solidarity is power.

My concern is that self-differentiation, economic and family issues, and what is portrayed as a comfortable life may influence choice. Variety is not only the spice of life, it has been shown to positively affect physician happiness. We do not want to see a dissatisfied generation of family doctors stuck in monotonous care systems. If large systems that respect diversity of practice and clinical autonomy and encourage innovation are featured and celebrated by graduates, the industrialized health systems will have to change toward that model of care if they want to recruit new family doctors. Word has a way of getting out.

Notes

  • To see this article online, please go to: http://jabfm.org/content/31/5/829.full.

  • The above letter was referred to the author of the article in question, who offers the following reply.

Reference

  1. 1.↵
    1. Peterson LE,
    2. Fang B,
    3. Puffer JC,
    4. Bazemore AW
    . Wide gap between. preparation and scope of practice of early career family physicians J Am Board Fam Med. 2018;31:181–82.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 31 (5)
The Journal of the American Board of Family Medicine
Vol. 31, Issue 5
September-October 2018
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Back Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Re: Wide Gap between Preparation and Scope of Practice of Early Career Family Physicians
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
2 + 3 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Re: Wide Gap between Preparation and Scope of Practice of Early Career Family Physicians
John J. Frey
The Journal of the American Board of Family Medicine Sep 2018, 31 (5) 829; DOI: 10.3122/jabfm.2018.05.180142

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Re: Wide Gap between Preparation and Scope of Practice of Early Career Family Physicians
John J. Frey
The Journal of the American Board of Family Medicine Sep 2018, 31 (5) 829; DOI: 10.3122/jabfm.2018.05.180142
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Notes
    • Reference
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • An Approach to Hair Loss in Hijab-Wearing Individuals in Primary Care
  • Re: Impact of Geodemographic Factors on Antibiotic Prescribing for Acute, Uncomplicated Bronchitis or Upper Respiratory Tract Infection
  • Re: Diversity of Department Chairs in Family Medicine at US Medical Schools
Show more Correspondence

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2023 American Board of Family Medicine

Powered by HighWire