Researchers Explore Diminishing Scope of Family Physician Practice

A new policy brief looks at the gap between family physicians' preparation for practice and the actual scope of practice for early-career family physicians. The brief, which was published in the March/April 2018 issue of Journal of the American Board of Family Medicine, was written by researchers from the American Board of Family Medicine (ABFM), the Department of Family and Community Medicine at the University of Kentucky, and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care. The researchers used data from the 2016 National Graduate Survey and based its findings on responses from 1,617 ABFM diplomates who completed residency in 2013. The survey included questions about whether participants were trained to practice—and were actually practicing—25 specific services. The largest gaps between preparation and practice were for maternity care (91% trained vs. 27% practicing), newborn hospital care (89% vs. 28%), neonatal circumcision (83% vs. 22%), and pediatric hospital care (77% vs. 21%). Behavioral health care was the only category in which practice (92%) exceeded preparation (88%). The researchers noted that more than 50% of physicians report that they are employed, and suggested that it is possible that employers are influencing the scope of practice for family physicians. For more information, go to https://www.aafp.org/news/practice-professional-issues/20180418scope.html.

CMS Releases New 2018 MIPS Eligibility Tool

The Centers for Medicare and Medicaid Services (CMS) has released an updated web-based tool to assist physicians in checking their eligibility status for the 2018 Merit-based Incentive Payment System (MIPS). To reduce the reporting burden on small practices, CMS has changed the eligibility threshold for 2018 to exclude clinicians and groups from MIPS if they bill $90,000 or less in Medicare Part B allowed charges for covered professional services under the physician fee schedule, or furnish services covered under the physician fee schedule to 200 or fewer Medicare Part B patients. Therefore, physicians will be identified for participation in the 2018 MIPS performance period if they have billed more than $90,000 in Medicare Part B allowed charges and provided professional services to more than 200 Medicare Part B enrolled beneficiaries. CMS noted that another tool that allows physicians to look up their participation status for the 2018 alternative payment model will be updated soon. For more information, go to https://www.aafp.org/news/macra-ready/20180411mipstool.html.

Researchers Address How to Maintain Interest in Providing Maternity Care

The number of family physicians who provide maternity care is declining, and that fact undermines the promise of comprehensive “cradle-to-grave” care that is the foundation of family medicine. Researchers investigated the intent of graduating family medicine residents to provide such care, then linked residents with their programs to find associations between residencies and intentions to provide maternity care. Based on data collected from 2014–2016 graduating family medicine residents, researchers determined that nearly 25% intended to provide obstetric delivery services and more than 50% intended to provide prenatal care. Residency characteristics associated with intent to provide deliveries and prenatal care included funding as a teaching health center, training based in a federally qualified health center, additional months of required maternity care rotations, existence of a residency-based maternity care fellowship, and a larger residency class size. The researchers noted that if family medicine values the provision of maternity care, efforts may need to be taken to encourage residency programs to require increased maternity care exposure. For more information, go to https://www.aafp.org/news/practice-professional-issues/20180411maternitycare.html.

Health Groups Sue FDA Over Delay in Regulating E-Cigarettes

A group of health organizations and individual health care professionals led by the American Academy of Pediatrics has sued the U.S. Food and Drug Administration (FDA) over a delay in the regulation of e-cigarettes and other tobacco products. The plaintiffs allege that a 2017 guidance document published by the FDA is unlawful and should be set aside. The guidance document extends compliance deadlines to obtain premarketing approval for certain tobacco products, such as e-cigarettes, for several years. The lawsuit comes amid mounting evidence of a dramatic rise in use of e-cigarettes among youth and young adults. A 2016 surgeon general's report estimated that e-cigarette use among high-school students increased 900% between 2011 and 2015. For more information, go to https://www.aafp.org/news/health-of-the-public/20180416fdalawsuit.html.

—AFP and AAFP NEWS STAFF

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