Between 2003 and 2009, the board certification process is being changed in family medicine and all the other American Specialty Boards to a series of tests to be conducted yearly on the different areas within the given specialty. The American Board of Family Medicine as well as other specialty boards is necessitating additional participation in continuous learning and self-assessments programs to enhance clinical knowledge, skills and expertise. The American Board of Family Medicine has created the Maintenance of Certification Program for Family Physicians which are requiring them to continuously demonstrate proficiency and efficiency in the four major areas of clinical practice namely: professionalism, self-assessment or lifelong learning, cognitive expertise and performance practice.
Adolescent medicine, geriatrics medicine, sports medicine, sleep medicine and hospice and palliative care medicine are some of the areas given the Certificates of Added Qualifications for the board-certified Family Physicians who have met the additional training and testing requirements. Fellowships are available as well in similar areas.
The paradigm of Family Medicine is bolstered by primary health care physicians who are trained in internal medicine; although they are only trained in this specific area, it is the adult patients who provide majority of the patient base of several of the practices in family medicine. There are rising contingents in the United States for physicians who are dually-trained in internal medicine as well as pediatrics, which will only take four years to complete instead of the three-year completion for each of the specialty. In urban and suburban areas, there are a significant number of family medicine practices that do not provide obstetric services such as litigation issues and provider preference anymore. A trend among Family Physicians is to adopt the practice model called the micro-practice or Ideal Medical Practice that focuses on reducing their overhead and increase technology utilization. This system allows Family Physicians to spend more on patient interactions that result in higher satisfaction ratings.
Family Medicine in Canada performs specialized work in conditions pertaining to the reproductive disorders and reproduction. Family Physicians who are working in the hospital setting are called General Practitioners. Doctors working within an acute care setting collaborate with interdisciplinary teams that are associated with a number of services and programs to address the issues related to patient care and clinical practice. It is the doctor’s role to provide a full range of primary health care services that includes obstetrical care, newborn care and inpatient palliative care and consultation.