RT Journal Article SR Electronic T1 Drivers of Scope of Practice in Family Medicine: A Conceptual Model JF The Annals of Family Medicine JO Ann Fam Med FD American Academy of Family Physicians SP 217 OP 223 DO 10.1370/afm.2669 VO 19 IS 3 A1 Amy Russell A1 Jill Fromewick A1 Brittney Macdonald A1 Stephen Kimmel A1 Kara Franke A1 Kimberly Leach A1 Kathy Foley YR 2021 UL http://www.annfammed.org/content/19/3/217.abstract AB PURPOSE The purpose of this study was to explore family medicine graduates’ attitudes and perspectives on modifiable and unmodifiable factors that influenced their scope of practice and career choices. By understanding how these factors intersect to influence desired and actual scope of practice decisions, we hope to inform strategies to address training and health care workforce needs.METHODS During 5 focus group discussions, comprised of a total of 32 family physicians who either resided in or attended a residency program in western North Carolina, we explored family physicians’ attitudes and perspectives on their desired and actual scope of practice. We used thematic analysis to identify patterns in the qualitative data.RESULTS We created a conceptual framework to understand the complex factors which influence family physicians’ scope of practice. Personal factors were found to impact desired scope, while workplace, environmental, and population factors influenced actual scope of practice. Stressors in each of these 4 categories often caused family physicians to narrow their scope of practice. Our study highlights specific supports that, if in place, enable physicians to maintain their desired broad scope of practice.CONCLUSIONS Our study indicates that the national trend toward family physicians narrowing their scope of practice can be addressed by providing specific supports during training, residency, and mid-career. Understanding personal, workplace, environmental, and population factors that influence scope of practice can inform specific interventions that create desirable jobs for family physicians and improve their ability to meet changing population needs.