Does family practice at residency teaching sites reflect community practice?

Area of Science:

• Medical Education
• Family Medicine Research
• Health Services Research

Background:

• Family medicine programs aim to train residents and conduct research in community-based settings.
• This study evaluated patient characteristics in university-affiliated family practice residency programs.
• Comparison was made against national data from the National Ambulatory Medical Care Survey (NAMCS).

Purpose of the Study:

• To compare patient demographics and clinical encounters at family practice residency training sites with national data.
• To assess the representativeness of ambulatory teaching centers in family medicine residency programs.
• To inform curriculum development and research focus in family medicine training.

Main Methods:

• Data collected from 98 faculty and resident physicians at Northeastern Ohio Universities College of Medicine residency sites.
• Analysis of 1498 ambulatory patient visits during a randomly selected week (1991-1992).
• Comparison with 1990 NAMCS data for family physicians (FPs) and general practitioners (GPs).

Main Results:

• Residency sites served slightly higher proportions of children, women, Black patients, and those with Medicare/Medicaid.
• Undifferentiated symptoms were the most common reason for visits in both groups.
• High concordance in top reasons for visit (15/20) and diagnoses (14/20) between sites and national data.
• Residency sites provided more preventive/therapeutic services but fewer diagnostic services; fewer consultations were requested.

Conclusions:

• Family medicine residency training sites in Northeast Ohio provide patient care experiences similar to national practice patterns.
• The findings support the model of community-based ambulatory teaching centers for family medicine training.
• Residency programs offer valuable insights into primary care delivery and patient populations.