HealthDay News — Initial certifiers have a broader intended scope of practice than the actual scope of practice reported by current practitioners, according to a study published in the Journal of the American Medical Association, a theme issue on medical education.

Anastasia J. Coutinho, MD, from the University of Vermont in Burlington, and colleagues compared the intended scope of practice for American Board of Family Medicine (ABFM) initial certifiers at residency completion with self-reported actual scope of practice of recertifying family physicians. Cross-sectional data were collected from a practice demographic questionnaire. Data were included from 3,038 initial certifiers and 10 846 recertifiers who were registered for the 2014 ABFM Maintenance of Certification for Family Physicians examination.

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The researchers found that the mean scope score for initial certifier intended practice was significantly higher than that for recertifying physicians’ reported actual practices (17.7 versus 15.5; P < 0.001). Initial certifiers were more likely to report intending to provide all clinical services except pain management than recertifiers, including obstetric care (23.7 versus 7.7%), inpatient care (54.9 versus 33.5%), and prenatal care (50.2 versus 9.9%) (all P < 0.001).

“This pattern suggests that these differences are not generational, but whether they are due to limited practice support, employer constraints, or other causes remains to be determined,” the authors write.


Coutinho A, Cochrane A, Stelter K, Phillips R, Peterson L. Comparison of Intended Scope of Practice for Family Medicine Residents With Reported Scope of Practice Among Practicing Family Physicians. JAMA. 2015;314(22):2364-2372. doi:10.1001/jama.2015.13734.