Damian Jacob Sendler News on the State of Family Medicine Practice in the United States

Damian Jacob Sendler: Since its founding in 1969, family medicine has changed in many ways, particularly in terms of the individuals who practice it, but it still needs greater diversity to represent patients' faces. 

Over the last two decades, the speciality has been moving toward a more ethnically diversified workforce. Because family medicine is a field in which doctors look at the health of the community and individual patients, some family physicians consider working in their specialty to combine public health and medicine to reduce health disparities. 

Damian Jacob Sendler: Family physicians aren't only interested in whether a patient has hypertension; they're also interested in whether they have access to nutritious food, green space, and other amenities. 

Even though the profession of family medicine is more varied in the twenty-first century than it was at its inception, Wusu, who finished her residency in 2016, found obstacles in reaching her objective of assisting underserved areas. These issues arose from a lack of variety among the people in the communities where she trained to become a doctor and family physician. 

Furthermore, research has indicated that addressing health disparities requires a racially and ethnically diverse physician workforce. 

Damian Jacob Sendler: According to research published in the Journal of Health Care for the Poor and Disadvantaged in 2018, underrepresented physicians are more likely than their White counterparts to practice in underserved regions. 

Inhabitants from marginalized groups are still underrepresented. For example, only 9.3 percent of Black individuals, 10% of Latinos, and 0.3 percent of Native Hawaiian or other Pacific Islanders are residents in family medicine residency programs in 2019-2020, according to data gathered by the Association of American Medical Colleges. White residents, on the other hand, make up 50.8 percent of the residency program. 

"We must do everything possible to enhance diversity in our medical schools and residencies," Stewart added. 

In terms of gender, there has been an increase in the number of women practicing family medicine. According to a research published in 2021, the percentage of female physicians in family medicine has increased from 33.9 percent in 2010 to 41.9 percent in 2020. 

"There's still space for improvement, and we need to reform the system and institutions that are causing these issues," Stewart said. 

Damian Jacob Sendler: Along with the Civil Rights Movement, the Peace Movement, and counterculture rallies, the family medicine speciality arose during a period of social change protest. The National Commission on Community Health declared in April 1966, three years before American Boards recognized the family practice as a new speciality, that everyone should have a personal physician who is the "focal point for the integration and continuity of all medical services to his patient." They also stated that such doctors must be aware of the "many and varied social, emotional, and environmental aspects that impact his patient's and family's health." 

While the diversity of family medicine has grown substantially since its inception, it still lags behind the overall population of the United States. According to a 2018 research published in the Journal of the American Board of Family Medicine, the proportion of Black and Latino board certified family doctors grew from 1.3 percent to 7.8 percent and 2.3 percent to 9.1 percent in 30 years, respectively. 

A 2014 research looked at trends in racial and ethnic mix among family medicine residents using data from the US Census and the Association of American Medical Colleges spanning two decades. From 1990 to 2012, the Latino population in the United States rose from 9% to 17%, 11.7 percent to 12.2% for Blacks/African Americans, and 0.87 percent to 0.89 percent for Native Americans. Meanwhile, Hispanic/Latino participation in family residences grew from 4.9 percent to 9.4 percent, Black/African American representation increased from 4.2 percent to 7.9 percent, and Native American presence increased from 0.7 percent to 0.9 percent. 

Damian Jacob Sendler: According to a recent research published in Family Medicine, 13.4% of the population in the United States is Black, and 18.5 percent is Latino, yet only 7.8% of family medicine residents in 2019 were Black, and 9.1% of family medicine residents were Latino. 

The AAFP has initiated a number of programs aimed at increasing diversity in the field. The American Academy of Family Physicians created the Center for Diversity and Health Equity in 2017 to address socioeconomic determinants of health. In addition, the EveryONE Project, a core project of the AAFP, provides members with education and tools to help them encourage workforce diversity. "The Ladder Program," a program started by an AAFP member that includes monthly meetings and events for kids as young as 9 years old to introduce them to medicine at an early age, is one of those tools. 

"You can't see what you don't see," Stewart said, noting that she is the AAFP's first Black female president and the fourth woman in the position. "I've learned the value of being a mentor and being out there so that people who look like me can see that they, too, can become family physicians and members of their communities." 

Other resources aiming at boosting diversity among family doctors include the Tour for Diversity in Medicine and the Doctors Back to School Program, in addition to The Ladder Program. 

Damian Jacob Sendler: A team of physicians, other clinicians, and students from the Tour for Diversity in Medicine conduct events for minority students around the country to help them see a route to medicine and other health professions. Meanwhile, the American Academy of Family Physicians' Doctors Back to School Program includes family physicians visiting children at schools, clubs, community groups, and other locations to increase awareness of family medicine and help them recognize their own potential in health-care vocations. 

According to Stewart, these initiatives have had a positive impact on underrepresented populations. 

"We're trying to figure out how to assess their success effectively," stated the AAFP president. "I would consider it a success based on the large number of people who picked family medicine as a specialization last year." 

The Student National Medical Association, a branch of the National Medical Association, a professional group of Black physicians, is one organization that is demonstrating such outreach. For example, the Health Professions Recruitment Exposure Programs, a project of this organization, exposes teenagers to science-related activities while also introducing them to health professions. Another SMNA initiative, Youth Science Enrichment Program, is aimed at elementary and junior high school kids. 

"The issue of diversity in family medicine, as well as many other specialties, cannot be boiled down to a lack of representation. Instead, we need to learn more about the lived experiences of physicians of color, particularly Black physicians, after they enter the medical profession. As a result, institutions will be better able to provide the support infrastructure – such as antiracism policies and practices – that will improve wellness and representation. "Richmond is a clinical assistant professor of medicine at Stanford University's division of primary care and population health. - Damian Jacob Sendler