Monday, February 1, 2016

Myth-busting and fact-sharing about Family Medicine

- Jennifer Middleton, MD, MPH

What career options exist for family physicians?
Can I afford to be a family physician?
How do family physicians keep up with the evidence base?

Medical students, other specialists, and even the lay public often have questions about Family Medicine. Kozakowski et al answer these questions and many more in "Responses to Medical Students' Frequently Asked Questions About Family Medicine" in the current issue of AFP. They provide information that debunks common myths about Family Medicine and also demonstrate Family Medicine's incredible breadth of career options:

Myth 1. Family physicians only work in outpatient settings seeing simple/boring problems like colds and minor injuries.

The authors review the numerous practice options available for family physicians:
As a family physician, you will be uniquely trained to provide comprehensive care for acute and chronic conditions, provide wellness care and disease prevention, perform a variety of procedures, and manage care through collaboration with other specialties.
True, most family physicians primarily practice in an outpatient setting, but many also provide inpatient and/or maternity care. Some work part- or full-time in urgent care centers or emergency departments. Most incorporate at least some procedures into their work, and some do a lot of them (see Table 2 for a comprehensive list). On average, we deal with a greater number of patient issues per visit than other specialists, and we're experts in understanding how co-morbid diseases affect each other. One of the reasons that I became a family doctor is the incredible variety of patients and conditions I see; I am never bored!

Myth 2. There's too much to keep up with in Family Medicine; I can't possibly know it all!

The authors tackle this one adeptly:
Family medicine residencies give you the core skills to manage most patient concerns comfortably, acknowledge your limitations, use your resources, and give you lifelong learning skills that allow you to grow and evolve with your patients and interests.
Students should actively seek Family Medicine residency programs that offer a comprehensive evidence-based medicine curriculum; the days where a monthly journal club might suffice are long past. Make sure that you will learn how to critically evaluate new studies, along with having ample mentoring regarding your personal reading plan. Using high-quality secondary literature review resources like AFP, it's more than possible to keep abreast of changes in the evidence base that should affect your practice, and residency is the perfect time to determine what resources you like and how you will integrate reviewing them into your schedule. Many family physicians also rely on social media to stay current with changes in medicine; AFP has a strong Facebook and Twitter presence, as do many other medical journals.

Myth 3. I won't be able to pay off my student loans if I become a family physician.

Family physician salaries are growing quickly in response to the increased need for primary care physicians in the United States. In addition, many health systems are offering sizable loan repayment benefits in their zeal to recruit family physicians (try putting "loan repayment family medicine" into your internet search engine and see what pops up). Fears about loan repayment should not keep individuals passionate about primary care out of our specialty.

On the flip side, here are some powerful facts about our specialty from the article:

Fact 1. A strong primary care infrastructure = higher quality health care at lower cost.

The authors review data showing that countries with a strong primary care base deliver better care for less cost; counties in the U.S. with the right proportion of primary care providers compared to other specialists show the same. Yes, we will always need the assistance of our colleagues in other specialties at times, but if you want to be part of the solution to improve health outcomes in the U.S., you can't go wrong choosing Family Medicine.

Fact 2. Training in Family Medicine provides excellent preparation for global health work.

Global health is about more than tropical diseases and unmet acute care needs; the authors point out that, increasingly, providing care for chronic diseases is equally important. No other specialty provides the breadth of training to prepare for the multitude of acute and chronic conditions at every age and stage of life that you may see across the globe besides Family Medicine.

Fact 3. Family physicians make great health care leaders.

Because we deal with whole human beings, and not isolated disease states, we are uniquely trained to look at the big picture with all of its inherent complexities. Besides this natural inclination to think broadly about challenges, no other specialty devotes as much time in residency training to understanding systems of care than Family Medicine. In addition, if you are passionate about advocating for your patients, AAFP provides a myriad of outlets to do so.

In an accompanying editorial to this special feature, Dr. Winklerprins and AFP's editor, Dr. Siwek, encourage all family doctors to share this article widely, especially with any medical students that you might mentor, since rotating with a family physician is often the most important factor influencing students' decision to join our specialty.

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