Most of the nation’s family physicians have transitioned from independent practices to employed settings, primarily within hospitals and health systems. At least two-thirds of family physicians say they have no ownership stake in their practices.1 To address the changing employment landscape and to position academic family medicine within health systems, STFM launched an initiative in May 2020.
Positioning Family Medicine and Preserving Scope of Practice
Over the past 2 years, the initiative, chaired by Christine Arenson, MD, engaged with health systems leaders to get their perspectives on the importance of family medicine within their organizations and on potential reasons for limited scope of practice. The initiative also worked with American Board of Family Medicine researchers to analyze data provided by family physicians on factors that influenced their scope of practice. A manuscript with the results of that analysis is in progress.
STFM published case studies about family medicine leaders during COVID (http://stfm.org/CovidLeaders) and developed Talking Points to Position Academic Family Medicine in Health Systems (https://stfm.org/TalkingToHealthSystemLeaders). The talking points have been shared with the family medicine community and have been used in the Health Systems Initiative presentations and publications.
Empowering Family Medicine Educators
Another area of focus for the initiative was helping family medicine faulty understand the systems in which they work so they can advocate for business-based solutions. The initiative selected Arch “Chip” Mainous, MD, as chair of a Health Systems Curriculum Task Force, which also included Margaret Baumgarten, MD; Jonathan Lichkus, MD, MPH; Sabrina Mitchell, DO; Margot Savoy, MD, MPH; and Mary Theobald, MBA.
The task force provided faculty development at national conferences, and also aggregated and produced online modules. The new modules are (1) Advocating Within Your Health System and (2) Analyzing Health Systems Data. The modules are available at https://stfm.org/healthsystems.
Next Steps
There is still work to be done to position academic family medicine in health systems. The plan approved by the STFM Board in April 2020 was for the first phase of what was intended to be a multiphased initiative. While staff efforts and resources are turning to new initiatives, such as antiracism, supporting underrepresented in medicine (URiM) faculty, and residency redesign, many of the tactics from the original plan are woven into ongoing work of STFM, particularly in the areas of addressing scope of practice in residency training, advocating for protected faculty time, and encouraging health systems to promote and reward precepting.
- © 2022 Annals of Family Medicine, Inc.