Chapter 1- family physician EXAM Questions AND Correct Answers
(two programs), and family medicine and internal medicine
(two programs). These combined residencies make candidates
eligible for certification by both specialty boards
with 1 year less training than that required for two
separate residencies through appropriate overlap of training
requirements. - ✔✔Definitions
FAMILY MEDICINE
Family medicine is the medical specialty that provides continuing
and comprehensive health care for the individual
and the family. It is the specialty in breadth that integrates
the biologic, clinical, and behavioral sciences. The scope of
family medicine encompasses all ages, both genders, each
organ system, and every disease entity.
In many countries, the term general practice is synonymous
with family medicine. The Royal New Zealand
College of General Practitioners emphasizes that a general
practitioner provides care that is "anticipatory as well as
responsive and is not limited by the age, sex, race, religion,
or social circumstances of patients, nor by their physical or
mental states." The general practitioner must be the
patient's advocate; must be competent, caring, and compassionate;
,must be able to live with uncertainty; and must be
willing to recognize limitations and refer when necessary
(Richards, 1997).
100,000 population, which is a 9% reduction in mortality
rate. Specialists practicing outside their area have increased
mortality rates for patients with acquired pneumonia, acute
myocardial infarction, congestive heart failure, and upper
gastrointestinal hemorrhage. A study of the major determinants
of health outcomes in all 50 U.S. states found that
when the number of specialty physicians increases, outcomes
are worse, but mortality rates are lower where there
are more primary care physicians (Starfield et al., 2005).
Veerappa and colleagues (2011) found that increasing
the number of family physicians practicing in the commu -
✔✔community
is associated with reduced hospital readmissions and
substantial cost savings. Thirty-day hospital readmission
rates for pneumonia, heart attack, and heart failure
decrease as the number of family physicians in the community
increases. Conversely, increased numbers of physicians
in all other major specialties (including general
,internal medicine) are associated with increased risk of
readmission (Figure 1-2).
A comparison of family physicians and obstetriciangynecologists
in the management of low-risk pregnancies
showed no difference with respect to neonatal outcomes.
However, women cared for by family physicians had fewer
cesarean sections and episiotomies and were less likely to
receive epidural anesthesia (Hueston et al., 1995).
Patients of subspecialists practicing outside their specialty
have longer lengths of hospital stay and higher mortality
rates than patients of subspecialists practicing within
their specialty (Weingarten et al., 2002). The quality of the
U.S. health care system is being eroded by physicians being
About 45% of Americans have a chronic condition. The
costs to individuals and to the health care system are enormous.
In 2000, care of chronic illness consumed 75 cents
of every health care dollar spent in the United States (Robert
Wood Johnson Foundation Annual Report, 2002).
Comorbidity, the coincident occurrence of coexisting and
apparently unrelated disorders, is increasing as the population
ages. Those age 60 years or older have an average of
, 2.2 chronic conditions, and physicians in primary care
provide most of this care (Bayliss et al., 2003).
Diabetes is one of the most rapidly increasing chronic
conditions. Quality of life is enhanced when care of patients
with diabetes is provided in a primary care setting without
compromising quality of care (Collins et al., 2009 - ✔✔Quality of Care
Primary care provided by physicians specifically trained to
care for the problems presenting to personal physicians,
who know their patients over time, is of higher quality than
care provided by other physicians. This has been confirmed
by a variety of studies comparing the care given by physicians
in different specialties. When hospitalized patients
with pneumonia are cared for by family physicians or fulltime
specialist hospitalists, the quality of care is comparable,
but the hospitalists incur higher hospital charges
and longer lengths of stay and use more resources (Smith
et al., 2002).
In the United States, a 20% increase in the number of
primary care physicians is associated with a 5% decrease in
mortality (40 fewer deaths per 100,000 population), but
the benefit is even greater if the primary care physician is a
family physician. Adding one more family physician per
(two programs), and family medicine and internal medicine
(two programs). These combined residencies make candidates
eligible for certification by both specialty boards
with 1 year less training than that required for two
separate residencies through appropriate overlap of training
requirements. - ✔✔Definitions
FAMILY MEDICINE
Family medicine is the medical specialty that provides continuing
and comprehensive health care for the individual
and the family. It is the specialty in breadth that integrates
the biologic, clinical, and behavioral sciences. The scope of
family medicine encompasses all ages, both genders, each
organ system, and every disease entity.
In many countries, the term general practice is synonymous
with family medicine. The Royal New Zealand
College of General Practitioners emphasizes that a general
practitioner provides care that is "anticipatory as well as
responsive and is not limited by the age, sex, race, religion,
or social circumstances of patients, nor by their physical or
mental states." The general practitioner must be the
patient's advocate; must be competent, caring, and compassionate;
,must be able to live with uncertainty; and must be
willing to recognize limitations and refer when necessary
(Richards, 1997).
100,000 population, which is a 9% reduction in mortality
rate. Specialists practicing outside their area have increased
mortality rates for patients with acquired pneumonia, acute
myocardial infarction, congestive heart failure, and upper
gastrointestinal hemorrhage. A study of the major determinants
of health outcomes in all 50 U.S. states found that
when the number of specialty physicians increases, outcomes
are worse, but mortality rates are lower where there
are more primary care physicians (Starfield et al., 2005).
Veerappa and colleagues (2011) found that increasing
the number of family physicians practicing in the commu -
✔✔community
is associated with reduced hospital readmissions and
substantial cost savings. Thirty-day hospital readmission
rates for pneumonia, heart attack, and heart failure
decrease as the number of family physicians in the community
increases. Conversely, increased numbers of physicians
in all other major specialties (including general
,internal medicine) are associated with increased risk of
readmission (Figure 1-2).
A comparison of family physicians and obstetriciangynecologists
in the management of low-risk pregnancies
showed no difference with respect to neonatal outcomes.
However, women cared for by family physicians had fewer
cesarean sections and episiotomies and were less likely to
receive epidural anesthesia (Hueston et al., 1995).
Patients of subspecialists practicing outside their specialty
have longer lengths of hospital stay and higher mortality
rates than patients of subspecialists practicing within
their specialty (Weingarten et al., 2002). The quality of the
U.S. health care system is being eroded by physicians being
About 45% of Americans have a chronic condition. The
costs to individuals and to the health care system are enormous.
In 2000, care of chronic illness consumed 75 cents
of every health care dollar spent in the United States (Robert
Wood Johnson Foundation Annual Report, 2002).
Comorbidity, the coincident occurrence of coexisting and
apparently unrelated disorders, is increasing as the population
ages. Those age 60 years or older have an average of
, 2.2 chronic conditions, and physicians in primary care
provide most of this care (Bayliss et al., 2003).
Diabetes is one of the most rapidly increasing chronic
conditions. Quality of life is enhanced when care of patients
with diabetes is provided in a primary care setting without
compromising quality of care (Collins et al., 2009 - ✔✔Quality of Care
Primary care provided by physicians specifically trained to
care for the problems presenting to personal physicians,
who know their patients over time, is of higher quality than
care provided by other physicians. This has been confirmed
by a variety of studies comparing the care given by physicians
in different specialties. When hospitalized patients
with pneumonia are cared for by family physicians or fulltime
specialist hospitalists, the quality of care is comparable,
but the hospitalists incur higher hospital charges
and longer lengths of stay and use more resources (Smith
et al., 2002).
In the United States, a 20% increase in the number of
primary care physicians is associated with a 5% decrease in
mortality (40 fewer deaths per 100,000 population), but
the benefit is even greater if the primary care physician is a
family physician. Adding one more family physician per
