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Healthcare News and Trends

The Future of Family Medicine

July 19, 2018

By Jennifer Larson, contributor

No one can predict the future, but family medicine physicians and leaders have high hopes for their specialty over the next several years.

They envision that more people and organizations will recognize and embrace the value of primary care--and its providers.

They hope that health insurance companies and other payers will align their payments and reimbursements to family medicine physicians and other primary care providers accordingly.

They expect that more family physicians will share their experiences with medical students and residents and encourage them to consider a career in primary care.

And every family medicine physician can be an active part of achieving these goals, according to Glen Stream, MD, MBI, president and board chair of Family Medicine for America’s Health (FMAHealth), a collaboration among America’s top family medicine organizations.

Stream likes to quote management consultant, educator, and author Peter Drucker: “The best way to predict the future is to create it.”

“We have to band together as colleagues and advocate with health plans and to employers and governments to get them to understand the need to look at primary care differently and pay for it differently and better,” he said.

FIND top family medicine jobs across the U.S., with Merritt Hawkins.

Physician shortages and demand for family physician jobs

According to the latest data from the U.S. Bureau of Labor Statistics in May 2017, there are approximately 126,440 family medicine physicians in the country today. Most are based in physicians’ offices; in fact, family physician jobs in medical offices account for more than 83,000 of the total.

But will there be enough family physicians in the future?

In spring 2018, the Association of American Medical Colleges (AAMC) predicted that the physician shortage could range from 42,600 to 121,300 physicians by 2030. Primary care physicians, including those who practice family medicine, represent a sizeable chunk of that shortfall.

Thus, family physicians continue to be in demand.

For the 12th consecutive year, family medicine physicians topped the list of Merritt Hawkins’ most requested recruiting assignments, according to the 2018 Review of Physician and Advanced Practitioner Recruiting Incentives, although the overall number has declined in recent years.

The Merritt Hawkins team reports strong demand for primary care physicians at a growing number of settings, including physicians trained in family medicine who work at urgent care clinics or telemedicine-based practices. Family nurse practitioners have also been climbing the list of the most requested candidates on Merritt Hawkins’ annual review.

The AAMC’s 2018 report predicted that demand for physicians will increase in the long run, with more emphasis placed on achieving population health goals such as helping patients reduce excess body weight; improve control of their blood pressure, cholesterol and blood glucose levels; and stop smoking.

These types of goals are directly in line with the type of care that family medicine physicians provide.

Shifting payment models could benefit family medicine

Family medicine physician David Hatfield, DO, and his colleagues with the Hatfield Medical Group in Arizona already focus on population health management and value-based healthcare delivery, so a shift toward value-based payments is a positive move for their type of practice. It acknowledges and rewards them for what they do to help people live healthier lives, while cutting costs.

The value-based care model is solid because it’s based upon collected data, noted Jim Schafer, who serves as population health strategist for Hatfield Medical Group. “Value-based care isn’t going away,” he said.

In the future, payment models could be refined to acknowledge everyone’s need for primary care while differentiating it from insurable events, suggested Stream.

He explained that people need ongoing care—including prevention and wellness—that starts at birth and continues throughout their lives. Many also need consistent management of chronic illnesses that tend to develop with age.

Payment for this type of ongoing primary care could be separated from insurance-based payment for events, like care for a person who was injured in a car accident and needed trauma services or suffered a stroke and needed rehabilitation.

“We are advocating for a greater understanding of how primary care can help with not just individual people and families, but communities and the whole country-and for the payment system to recognize that,” said Stream.

If payment is better aligned with the care that family physicians provide, it could be an incentive for more young doctors to consider this specialty, and possibly make a dent in the predicted shortage. That could strengthen the primary care workforce.

Hatfield wants young doctors to know that they can make a real difference in people’s lives if they choose to practice family medicine.

“If you love relationships, then go into primary care,” he said.

Where will family medicine jobs be?

So where will those future family physician jobs be?

An ongoing trend toward physician employment, and away from private practice ownership, may continue to affect family medicine physicians.

An updated study on physician practice arrangements released by the American Medical Association (AMA) in May 2017 noted that it’s becoming less common for physicians to own an independent practice.

The study found that practice ownership for physicians declined from 53.2 percent in 2012 to 47.1 percent in 2016. At the same time, a growing number of physicians took on employed positions; that percentage grew from 41.8 percent in 2012 to 47.1 percent in 2016.

MERRITT HAWKINS offers more career opportunities and job placement services for physicians and advanced practitioners across the U.S.

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