A Family Physician is certified in and practices the discipline of Family Medicine, the medical specialty which provides continuing and comprehensive health care for the individual and the family. It is the specialty in breadth which integrates the biological, clinical and behavioral sciences. The scope of Family Medicine encompasses all ages, both sexes, each organ system and every disease entity.

Americans Receive Vital Primary Care Services from Family Physicians

Family physicians are the backbone of Louisiana's and America's health infrastructure.

o A family physician treats one out of every 4 patients in the US. In fact, more than 210 million office visits are made to family physicians each year. This is 76 million more than any other medical specialty.

o More than 12 times as many people are seen in primary care physicians' offices in the US as in hospitals. The statistics are similar for children.

o More Americans depend on family physicians than any other medical specialty. Without family physicians, the majority of US counties would become Health Professions Shortage Areas.

o Family physicians are the main source of primary health care for the Medicare population. Sixty percent of people aged 65 and older identify a family physician as their usual source of care. In addition, rural and Hispanic seniors are more likely to identify a family doctor as their source of care.

o Nearly one-half of the physicians who staff the nation's Community Health Centers are family physicians. Since 1971, the National Health Service Corps has placed more than 18,000 health care providers in underserved areas: almost half of the NHSC doctors were family physicians.

o 82 percent of Americans have a "usual source of medical care" and the majority of them name a family physician.

Louisiana, as a predominantly rural state, needs to pay particular attention to the family physician work force.

o Family Physicians are up to 8 times more likely then any other specialty to practice in rural locations. In addition, due to the breadth of their training family physicians is the specialty ideally suited for rural practice.

o The primary care work force is inadequate. Currently, less than 1/3 of Louisiana physicians are dedicated to primary care practice, while 25% of Louisiana's 1100 family physicians are age 60 or above.

Americans depend on family physicians more than any other specialty, especially to avoid health professional shortage areas.

o A study by the Graham Center in Washington shows looked at parishes/counties designated as Primary Care Health Professions Shortage Areas (HPSAs). Of the 3142 counties in the United States, 1184 (38 percent) are designated full or partial county HPSAs, which translates to more than 41 million Americans.

o In a hypothetical exercise, the study removed all family physicians from the US parishes/counties. When this was done, that figure nearly doubles - the large majority of US counties became full or partial county HPSAs.

o In Louisiana, 86% of parishes are already full or partial HPSAs.

Invest in the Health Care System: Train Family Physicians

A Primary Care Workforce Can Improve Quality and Lower Costs

o An article in Health Affairs (April 2004) demonstrates that higher Medicare spending is associated with lower quality of care for many common conditions. Louisiana's Medicare spending (at $8,238 per year per beneficiary) is highest of any state, while Louisiana ranks lowest (51st) on quality measures

o The authors suggest that more specialists and fewer generalists in a State mean higher costs and lower quality. The study showed that workforce measures explain 42 percent of the variation in Medicare spending between states. Moreover, just a small increase in the number of generalists in a state was associated with a large boost in that state's quality ranking.

To assure the production of adequate numbers of family physicians, explicit strategies should be adopted to support their training. The academic medical centers have failed to prioritize the preparation of this work force, resulting in the disproportionate sub specialization and urban location of the physician work force.

o Entry by US medical graduates into family medicine training has declined.

o Despite the increase in the supply of physicians over the last 20 years, the percentage practicing primary care and the proportion of all physicians practicing in rural areas relative to urban areas have both declined.

o A change in Medical School Admissions practice to one that supports both goals of primary care practice as well as the rural location of future physicians has been shown to be the single most important factor to influence the production of future rural primary care practitioners.

o Adequate exposure to clinical training experiences and role models in community-based primary care must be provided and supported both during medical school and residency.

o The financial burden borne by students as a result of their medical education is a barrier to primary care careers.