The future of family medicine: A collaborative project of the family medicine community

被引:476
作者
Gorey, TM
Kahn, NB
Thomas, S
McMillen, MA
机构
[1] Amer Acad Family Phys, Leawood, KS 66211 USA
[2] CHRISTUS Santa Rosa Hlth Care, Family Practice Residency Program, San Antonio, TX USA
[3] Amer Board Family Practice, Lexington, KY USA
[4] Univ Penn, Dept Family Practice & Community Med, Hlth Syst, Philadelphia, PA 19104 USA
[5] Columbus Family Practice Residency Program, Columbus, GA USA
[6] Univ Rochester, Sch Med & Dent, Dept Family Med, Rochester, NY USA
[7] Robert Graham Ctr, Washington, DC USA
[8] Univ Colorado, Dept Family Med, Denver, CO 80202 USA
[9] Amer Acad Family Phys, Leawood, KS USA
[10] Univ Kentucky, Dept Family Practice & Community Med, Lexington, KY USA
[11] Christiana Care Hlth Syst, Dept Family & Community Med, Wilmington, DE USA
[12] Amer Acad Family Phys Fdn, Leawood, KS USA
[13] Univ Wisconsin, Dept Family Med, Madison, WI USA
[14] Univ Med & Dent New Jersey, Sch Community Hlth, New Brunswick, NJ USA
[15] Soc Teachers Family Med, Leawood, KS USA
[16] Case Western Reserve Univ, Dept Family Med, Columbus, OH USA
关键词
D O I
10.1370/afm.130
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
BACKGROUND Recognizing fundamental flaws in the fragmented US health care systems and the potential of an integrative, generalist approach, the leadership of 7 national family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. The goal of the project was to develop a strategy to transform and renew the discipline of family medicine to meet the needs of patients in a changing health care environment. METHODS A national research study was conducted by independent research firms. Interviews and focus groups identified key issues for diverse constituencies, including patients, payers, residents, students. family physicians, and other clinicians. Subsequently, interviews were conducted with nationally representative samples of 9 key constituencies. Based in part on these data, 5 task forces addressed key issues to meet the project goal. A Project Leadership Committee synthesized the task force reports into the report presented here. RESULTS The project identified core values, a New Model of practice, and a process for development, research, education, partnership, and change with great potential to transform the ability of family medicine to improve the health and health care of the nation. The proposed New Model of practice has the following characteristics: a patient-centered team approach; elimination of barriers to access, advanced information systems, including an electronic health record; redesigned, more functional offices, a focus on quality and outcomes; and enhanced practice finance. A unified communications strategy will be developed to promote the New Model of family medicine to multiple audiences. The study concluded that the discipline needs to oversee the training of family physicians who are committed to excellence. steeped in the core values of the discipline, competent to provide family medicine's basket oil services within the New Model, and capable of adapting to varying patient needs and changing care technologies. Family medicine education must continue to include training in maternity care, the care of hospitalized patients, community and population health, and culturally effective and proficient care. A comprehensive lifelong learning program for each family physician will support continuous personal, professional. and clinical practice assessment and improvement. Ultimately, systemwide changes will be needed to ensure high-quality health care for all Americans. Such changes. include taking steps to ensure that every American has a personal medical home, promoting the use and reporting of quality measures to improve performance and service, advocating that every American have health care coverage for basic services and protection against extraordinary health care costs, advancing research that supports the clinical decision making of family physicians and other primary care clinicians, and developing reimbursement models to sustain family medicine and primary care practices. CONCLUSIONS The leadership of US family medicine organizations is committed to a transformative process, In partnership with others, this process has the potential to integrate health care to improve the health of all Americans.
引用
收藏
页码:S3 / S32
页数:30
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