Comprehensive Practice Among Western Family Medicine Graduates: A Cross-Sectional and Longitudinal Analysis
Abstract
Comprehensiveness represents medical care provided across settings and services that meets patients’ needs across life stages and clinical presentations. Yet, comprehensiveness has declined over time as family physicians (FPs) narrow their scopes of practice. This thesis aims to describe comprehensiveness among FPs examining changes over time and physician-and clinic-related predictors of comprehensiveness. Cross-sectional and longitudinal analyses were conducted on the 2009, 2014, and 2020 waves of the Western Family Medicine Resident Follow-Up Survey. Based on an OfficeCare+ definition of comprehensiveness, an average 76% of FPs practiced comprehensively across surveys and stayed comprehensive. FPs who had completed a PGY3 program were less likely to be comprehensive than FPs who had not. FPs in capitation-based funding models were more likely to be comprehensive than FPs in fee-for-service funding models. Stratification by urban and rural practice location uncovered differences in comprehensiveness. Findings provide insight on health system management and physician workforce planning.