Drivers of Scope of Practice in Family Medicine: A Conceptual Model
Drivers of Scope of Practice in Family Medicine: A Conceptual Model
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DOI：
10.1370/afm.2669
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发表时间：
2021-05-01
影响因子：
4.4
通讯作者：
Foley, Kathy
中科院分区：
文献类型：
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作者：
Russell, Amy;Fromewick, Jill;Foley, Kathy
目的探讨家庭医学专业毕业生对影响其执业范围和职业选择的可改变和不可改变因素的态度和观点。通过了解这些因素如何交叉影响所需的和实际的实践决策范围，我们希望告知战略，以解决培训和卫生保健劳动力的需求.METHODS在5焦点小组讨论，共32名家庭医生谁要么居住或参加了居住计划在西部北卡罗来纳州，我们探讨了家庭医生对他们期望的和实际的执业范围的态度和观点。我们使用主题分析，以确定在定性data.RESULTS模式，我们创建了一个概念框架，以了解影响家庭医生的执业范围的复杂因素。个人因素被发现影响所需的范围，而工作场所，环境和人口因素影响实际的实践范围。这4类压力源往往导致家庭医生缩小他们的执业范围。我们的研究突出了具体的支持，如果到位，使医生保持他们所需的广泛的practice.CONCLUSIONS范围，我们的研究表明，家庭医生缩小他们的执业范围的国家趋势，可以通过提供具体的支持，在培训，居住，和职业生涯中期。了解影响实践范围的个人，工作场所，环境和人口因素可以为特定的干预措施提供信息，为家庭医生创造理想的工作岗位，并提高他们满足不断变化的人口需求的能力。
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.