A needs-based method for estimating the behavioral health staff needs of community health centers.

Background: Federally Qualified Health Centers are expanding to increase access for millions of more Americans with a goal of doubling capacity to serve 40 million people. Health centers provide a lot of behavioral health services but many have difficulty accessing mental health and substance use professionals for their patients. To meet the needs of the underserved and newly insured it is important to better estimate how many behavioral health professionals are needed.

Toward graduate medical education (GME) accountability: measuring the outcomes of GME institutions.

Purpose: Graduate medical education (GME) plays a key role in the U.S. health care workforce, defining its overall size and specialty distribution and influencing physician practice locations.

Most family physicians work routinely with nurse practitioners, physician assistants, or certified nurse midwives.

The U.S. physician workforce is struggling to keep pace with the demand for health care services, a situation that may worsen without efforts to enhance team-based care.

The association between global health training and underserved care: early findings from two longstanding tracks.

Background And Objectives: Global health tracks (GHTs) improve knowledge and skills, but their impact on career plans is unclear. The objective of this analysis was to determine whether GHT participants are more likely to practice in underserved areas than nonparticipants.

Methods: In this retrospective cohort study, using the 2009 American Medical Association Masterfile, we assessed the practice location of the 480 graduates from 1980--2008 of two family medicine residencies-Residency 1 and Residency 2.

Trends in physician supply and population growth.

The physician workforce has steadily grown faster than the U.S. population over the past 30 years, context that is often absent in conversations anticipating physician scarcity.

Family physicians are essential for mental health care delivery.

As the largest and most widely distributed of primary care physicians, family physicians have an important role in providing mental health care, especially in rural and underserved areas. However, the proportion of family physicians who report providing mental health care is low. Policy barriers such as payment for mental health services should be explored to ensure access to mental health care for patients across the urban to rural continuum.

The rise of electronic health record adoption among family physicians.

Purpose: Realizing the benefits of adopting electronic health records (EHRs) in large measure depends heavily on clinicians and providers' uptake and meaningful use of the technology. This study examines EHR adoption among family physicians using 2 different data sources, compares family physicians with other office-based medical specialists, assesses variation in EHR adoption among family physicians across states, and shows the possibility for data sharing among various medical boards and federal agencies in monitoring and guiding EHR adoption.

Method: We undertook a secondary analysis of American Board of Family Medicine (ABFM) administrative data (2005-2011) and data from the National Ambulatory Medical Care Survey (NAMCS) (2001-2011).

A small percentage of family physicians report time devoted to research.

Despite calls by family medicine organizations to build research capacity within the discipline, few family physicians report research activity. Policy that supports efforts in family medicine research and increases awareness of opportunities for primary care research in the practice setting is essential for family medicine to expand its scholarly foundations.

Projecting US primary care physician workforce needs: 2010-2025.

Purpose: We sought to project the number of primary care physicians required to meet US health care utilization needs through 2025 after passage of the Affordable Care Act.

Methods: In this projection of workforce needs, we used the Medical Expenditure Panel Survey to calculate the use of office-based primary care in 2008. We used US Census Bureau projections to account for demographic changes and the American Medical Association's Masterfile to calculate the number of primary care physicians and determine the number of visits per physician.

Match rates into family medicine among regional medical campus graduates, 2007-2009.

Background: Regional medical campuses (RMCs) are geographically separate from parent campuses, have administrative ties to deans' offices, and offer at least 4 third-year clerkships. This study sought to describe the match rates into family medicine for graduates of RMCs and non-RMCs.

Methods: The authors obtained the 2007 to 2009 match lists from schools participating in the Association of American Medical College's Group on Regional Medical Campuses.

Trends in physician house calls to Medicare beneficiaries.

Objective: House calls (HCs) to older adults seemed to be headed for extinction in recent decades. HCs may be a tool to ensure access and reduce institutionalization of the elderly population. This study determines the number and distribution of HCs by physician specialty over time and analyzes associations of providing HCs with physician and area-level characteristics.

Engagement of family physicians in Maintenance of Certification remains high.

Maintenance of Certification for Family Physicians was created to enhance the quality of care delivered by family physicians but risked decreasing their engagement due to the increased burden of meeting additional requirements to remain board-certified. Participation by family physicians in Maintenance of Certification remains higher than predicted.

Family physicians in the maternity care workforce: factors influencing declining trends.

Family physicians provide access to maternity care for a disproportionate share of rural and urban underserved communities. This paper aims to determine trends in maternity care provision by family physicians and the characteristics of family physicians that provide maternity care. We used American Board of Family Medicine survey data collected from every family physician during application for the Maintenance of Certification Examination to determine the percentage of family physicians that provided maternity care from 2000 to 2010.

A reemerging political space for linking person and community through primary health care.

Objectives: We sought to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities.

Methods: We conducted 13 semistructured interviews in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard-defining organizations with influence over health care reform policies and implementation. We recorded the interviews and used an editing and immersion-crystallization analysis approach to identify themes.

Integrating community health centers into organized delivery systems can improve access to subspecialty care.

The Affordable Care Act is funding the expansion of community health centers to increase access to primary care, but this approach will not ensure effective access to subspecialty services. To address this issue, we interviewed directors of twenty community health centers. Our analysis of their responses led us to identify six unique models of how community health centers access subspecialty care, which we called Tin Cup, Hospital Partnership, Buy Your Own Subspecialists, Telehealth, Teaching Community, and Integrated System.

Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery.

Objective: To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area.

Data Sources/study Setting: Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were aggregated to primary care service areas (PCSAs).

The percentage of family physicians attending to women's gender-specific health needs is declining.

As the largest and most widely distributed of primary care physicians, family physicians have an important role in providing women's health care, especially in rural and underserved areas. The proportion of family physicians who are attending to women is declining. Policy intervention may be needed to help family physicians maintain the comprehensiveness of care necessary to address the wide range of medical problems of women they encounter within their practices.

A re-emerging political space for linking person and community through primary health care.

Purpose: The goal of the study was to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities.

Methods: Thirteen semistructured interviews were conducted in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard-defining organizations with influence over healthcare reform policies and implementation. Interviews were recorded; an editing and immersion-crystallization analysis approach was used to identify themes.

An International Health Track Is Associated With Care for Underserved US Populations in Subsequent Clinical Practice.

Background: Recent efforts to increase insurance coverage have revealed limits in primary care capacity, in part due to physician maldistribution. Of interest to policymakers and educators is the impact of nontraditional curricula, including global health education, on eventual physician location. We sought to measure the association between graduate medical education in global health and subsequent care of the underserved in the United States.

Proportion of family physicians providing maternity care continues to decline.

Family physicians traditionally have played an integral role in delivering babies as a component of the comprehensive care they provide for women. The proportion of family physicians who report providing any maternity care continues to decrease. This trend is particularly concerning because family physicians are the most widely distributed specialty and are essential to health care access in rural areas.

Declining numbers of family physicians are caring for children.

Despite continued growth of the primary care workforce, profound maldistribution persists among providers available for the care of children. Family physicians (FPs) spend, on average, approximately 10% of their total practice time caring for children; however, given that, among physician specialties, FPs are geographically distributed most evenly across the US population, the self-reported decline in the share of FPs caring for children should be disturbing to policymakers, especially with the looming insurance expansion in 2014.

Medical school rural programs: a comparison with international medical graduates in addressing state-level rural family physician and primary care supply.

Purpose: Comprehensive medical school rural programs (RPs) have made demonstrable contributions to the rural physician workforce, but their relative impact is uncertain. This study compares rural primary care practice outcomes for RP graduates within relevant states with those of international medical graduates (IMGs), also seen as ameliorating rural physician shortages.

Method: Using data from the 2010 American Medical Association Physician Masterfile, the authors identified all 1,757 graduates from three RPs (Jefferson Medical College's Physician Shortage Area Program; University of Minnesota Medical School Duluth; University of Illinois College of Medicine at Rockford's Rural Medical Education Program) practicing in their respective states, and all 6,474 IMGs practicing in the same states and graduating the same years.