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Welcome to First Care Medical Group! Our practice
provides primary care and urgent care services. Our offices are
staffed by family doctors, internists, occupational medicine doctors
and physician assistants. We are open for walk-in patients and for
scheduled appointments. New patients are welcome. We participate
with most insurance plans.
Family medicine
doctors in the United States may hold either an M.D. or a D.O.
degree. Physicians who specialize in family medicine (also known as
family physicians) must complete a three-year family medicine
residency in addition to their medical degree, and are eligible for
the board certification now required by most hospitals and health
plans.
The term "family medicine" is used in Canada and many European
countries instead of "general medicine" or "general practice". In
Sweden, certification in family medicine needs five years working
with tutor, after the medical degree. Similar systems have been
implemented in other countries.[citation needed]
Family physicians deliver a range of acute, chronic and preventive
medical care services. In addition to diagnosing and treating
illness, they also provide preventive care, including routine
checkups, health-risk assessments, immunization and screening tests,
and personalized counseling on maintaining a healthy lifestyle.
Family physicians also manage chronic illness, often coordinating
care provided by other subspecialists.
Nearly one in four of all office visits are made to family
physicians. That is 208 million office visits each year — nearly 83
million more than the next largest medical specialty. Today, family
physicians provide more care for America’s underserved and rural
populations than any other medical specialty.
Most family physicians practice in solo or small-group private
practices or as hospital employees in practices of similar sizes
owned by hospitals. However, the specialty is broad and allows for a
variety of career options including education, emergency medicine or
urgent care, inpatient medicine, international or wilderness
medicine, public health, sports medicine, and research. Others
choose to practice as consultants to various medical institutions,
including insurance companies.
Today, family physicians provide the majority of care for America's
underserved rural and urban populations. In fact, more than a third
of all U.S. counties, with a combined population exceeding 40
million Americans, depend on family physicians to avoid designation
as primary care health profession shortage areas.
Following World
War II, two events shaped the advent of family medicine. First,
medical specialties and subspecialties increased in popularity,
having an adverse affect on the number of physicians in general
practice. At the same time, many medical advances were being made
and there was concern within the "general practitioner" or "GP"
population that four years of medical school plus a one-year
internship was no longer adequate preparation for the breadth of
medical knowledge required of the profession. Many of these doctors
wanted to see a residency program added to their training; this
would not only give them additional training, knowledge, and
prestige, but would allow for board certification, which was
increasingly required to gain hospital privileges. In 1969, family
medicine (then known as family practice) was recognized as a
distinct specialty in the U.S.
Family physicians complete undergraduate school, medical school, and
three more years of specialized medical residency training in family
medicine. Their residency training includes rotations in internal
medicine, pediatrics, obstetrics-gynecology, psychiatry, and
geriatrics. The specialty focuses on treating the whole
person—acknowledging the effects of all outside influences—through
all life stages. Family physicians will see anyone with any problem,
but are experts in common problems. Many family physicians deliver
babies in addition to taking care of patients of all ages.
In order to become board certified, family physicians must complete
a residency in family medicine, possess a full and unrestricted
medical license, and take a written cognitive examination. Between
2003 and 2009, the process for maintenance of board certification in
family medicine is being changed (as well as all other American
Specialty Boards) to a series of yearly tests on differing areas.
The American Board of Family Medicine, as well as other specialty
boards, are requiring additional participation in continuous
learning and self-assessment to enhance clinical knowledge,
expertise and skills. The Board has created a program called the
"Maintenance of Certification Program for Family Physicians" (MC-FP)
which will require family physicians to continuously demonstrate
proficiency in four areas of clinical practice: professionalism,
self assessment/lifelong learning, cognitive expertise, and
performance in practice. Three hundred hours of continuing medical
education within the prior six years is also required to be eligible
to sit for the exam.
Family physicians may pursue fellowships in diverse topics including
adolescent medicine, geriatric medicine, sports medicine, sleep
medicine, and hospice and palliative medicine. The American Board of
Family Medicine offers Certificates of Added Qualifications (CAQs)
in each of these topics.
The family medicine (FM) paradigm is bolstered by primary care
physicians trained in internal medicine (IM); although these
physicians are trained in internal medicine only, adult patients
provide the majority of the patient base of many family medicine
practices.[citation needed] In the United States, there is a rising
contingent of physicians dually trained in internal medicine and
pediatrics, which can be completed in four years, instead of the
three years each for IM and pediatrics.[citation needed] A
significant number of family medicine practices (especially in
suburban and urban areas) do not provide obstetric services anymore
(due to litigation issues and provider preference), and as such,
this blurs the line between the FM and IM/Peds difference.[citation
needed] One suggested difference is that the IM/Peds-trained
physicians are more geared towards subspecialty training or
hospital-based practice.[citation needed] Even so, there are groups
with FM-trained and IM/Peds-trained physicians working in seamless
harmony.[citation needed]
While many sources cite a shortage of family physicians (and also
other primary care providers, i.e. internists, pediatricians, and
general practitioners)[16], the per capita supply of primary care
physicians has actually increased about 1 percent per year since
1998.[17] Additionally, a recent decrease in the number of M.D.
graduates pursuing a residency in primary care, has been offset by
the number of D.O graduates and graduates of international medical
schools (IMGs) who enter primary care residencies. Still,
projections indicate that by 2020 the demand for family physicians
will exceed their supply.
The number of students entering family medicine residency training
has fallen from a high of 3,293 in 1998 to 1,172 in 2008, according
to National Residency Matching Program data. Fifty-five family
medicine residency programs have closed since 2000, while only 28
programs have opened.
In 2006, when the nation had 100,431 family physicians, a workforce
report by the American Academy of Family Physicians indicated the
United States would need 139,531 family physicians by 2020 to meet
the need for primary medical care. To reach that figure 4,439 family
physicians must complete their residencies each year, but currently
the nation is attracting only half the number of future family
physicians that we will need.
The waning interest in family medicine is likely due to several
factors, including the lesser prestige associated with the
specialty, the lesser pay, and the increasingly frustrating practice
environment in the U.S. Salaries for family physicians in the United
States are respectable but lower than average for physicians, with
the average being $129,295 and ranging from $110,000 to
$204,000[21], but when faced with debt from medical school, most
medical students are opting for the higher paying specialties.
Family physicians are trained to manage acute and chronic health
issues for an individual simultaneously, yet their appointment slots
may average only ten minutes. Physicians are increasingly forced to
do more administrative work, and to shoulder higher malpractice
premiums, thus forcing doctors to spend less and less time with
patient care due to the current payor model stressing patient volume
vs. quality of care.[citation needed] Things are starting to change
as more insurance carriers consolidate.[citation needed] They are
not stressing performance but more and more volume, thus increasing
insurance company profit margins.[citation needed] Physicians are
starting to shun insurance carriers to lessen the paperwork in order
to focus more on patient care as they are originally trained to
do.[citation needed]
There is a current trend among family physicians to adopt a practice
model called the micro practice, or "Ideal Medical
Practice".[citation needed] These practices focus on reducing their
overhead and increase their utilization of technology.[citation
needed] Because the overhead is reduced, the need to see a high
volume of patients to generate more revenue is diminished. This
allows the doctor to spend more time with their patients, which
results in higher satisfaction for the patient and the physician.
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