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美国医疗实践中的全科医生与家庭医生比较。

General Practitioners in US Medical Practice Compared With Family Physicians.

机构信息

Department of Family Medicine, University of Washington, Seattle, Washington

American Board of Family Medicine, Lexington, Kentucky.

出版信息

Ann Fam Med. 2020 Mar;18(2):127-130. doi: 10.1370/afm.2503.

Abstract

PURPOSE

General practitioners (GPs) are part of the US physician workforce, but little is known about who they are, what they do, and how they differ from family physicians (FPs). We describe self-identified GPs and compare them with board-certified FPs.

METHODS

Analysis of data on 102,604 Doctor of Medicine and Doctor of Osteopathy physicians in direct patient care in the United States in 2016, who identify themselves as GPs or FPs. The study used linking databases (American Medical Association Masterfile, American Board of Family Medicine [ABFM], Area Health Resource File, Medicare Public Use File) to examine personal, professional, and practice characteristics.

RESULTS

Of the physicians identified, 6,661 self-designated as GPs and 95,943 self-designated as FPs. Of the self-designated GPs, 116 had been ABFM certified and were excluded from the study. Of the remaining 102,488 physicians, those who self-designated as GPs but were never ABFM certified constituted the GP group (n = 6,545, 6%). Self-designated FPs that were ABFM certified made up the FP group (n = 79,449, 78%). The remaining self-designated FPs not ABFM certified constituted the uncertified group (n = 16,494, 16%). GPs differed from FPs in every characteristic examined. Compared with FPs, GPs are more likely to be older, male, Doctors of Osteopathy, graduates of non-US medical schools, and have no family medicine residency training. GPs practice location is similar to FPs, but GPs are less likely to participate in Medicare or to work in hospitals.

CONCLUSIONS

GPs in the United States are a varied group that differ from FPs. Researchers, educators, and policy makers should not lump GPs together with FPs in data collection, analysis, and reporting.

摘要

目的

全科医生是美国医生队伍的一部分,但人们对他们是谁、他们做什么以及他们与家庭医生有何不同知之甚少。我们描述了自认为是全科医生的人,并将他们与经过委员会认证的家庭医生进行了比较。

方法

对 2016 年在美国直接为患者提供服务的 102604 名医学博士和骨科医生的数据进行分析,这些医生自认为是全科医生或家庭医生。该研究使用了链接数据库(美国医学协会主文件、美国家庭医学委员会 [ABFM]、地区卫生资源文件、医疗保险公共使用文件)来检查个人、专业和实践特征。

结果

在被识别的医生中,有 6661 名自我认定为全科医生,95943 名自我认定为家庭医生。在自我认定的全科医生中,有 116 名曾获得 ABFM 认证,被排除在研究之外。在剩下的 102488 名医生中,那些自我认定为全科医生但从未获得 ABFM 认证的医生构成了全科医生组(n=6545,6%)。自我认定的家庭医生获得 ABFM 认证构成了家庭医生组(n=79449,78%)。剩下的未获得 ABFM 认证的自我认定家庭医生构成了未认证组(n=16494,16%)。全科医生在每个被检查的特征上都与家庭医生不同。与家庭医生相比,全科医生更可能年龄较大、为男性、为骨科医生、毕业于非美国的医学院校,并且没有家庭医学住院医师培训。全科医生的执业地点与家庭医生相似,但全科医生不太可能参与医疗保险或在医院工作。

结论

美国的全科医生是一个多样化的群体,与家庭医生不同。研究人员、教育工作者和政策制定者在数据收集、分析和报告中不应该将全科医生与家庭医生混为一谈。

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