FIFTY COMPETENCIES FOR FAMILY MEDICINE

 

RIVERSIDE FAMILY MEDICINE RESIDENCY

 

 

Patient Care

PC      Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.  Residents are expected to:

 

PC-1A FP      conduct an interview that fosters an adequate and    helpful doctor-patient relationship using language that is clear and understandable;

 

PC-1B FP      communicate follow up results to patients in a timely manner;

 

PC-1C FP      demonstrate knowledge of and adherence to patient

confidentiality standards;

 

PC-2A            FP      identify the purpose of the visit;

 

PC-2B FP      conduct a focused evaluation of the presenting problem (including history, physical examination, and laboratory/radiological procedures);

 

PC-2C FP      update the biopsychosocial problem list and medication list at each visit;

 

PC-2D FP      completely document the patient care encounter in

the medical record in a concise and legible manner

following a problem-oriented format and using the SOAP notation;

 

PC-3A FP      develop appropriate biopsychosocial hypotheses

(differential diagnoses) that apply to the presenting

problem and choose appropriate interventions for the

presenting problem;

 

PC-4A FP      develop a plan of action that attends to salient medical, psychosocial, family, cultural and socioeconomic issues;

 

PC-4B            FP      implement the negotiated management plan by

completely documenting prescriptions, tests, patient

instructions,  referrals, return appointments and

properly filling out the billing sheet;

 

PC-4C FP      arrange for follow-up of the current problem that fits

the guidelines of current standards of care and

attends to the special needs of the patient, family or

caregiver;

 

PC-5A FP      conduct an encounter that recognizes the primacy of patient needs and treats the patient as an appropriately equal health care partner making sure that they understand their health issues;

 

PC-5B FP      present a provisional working diagnosis to the

patient;

 

PC-6A FP      exhibit patient care principles that incorporate the use of electronic technology in decision making;

 

PC-6B FP      provide the patient with information in a format that

will optimize patient understanding;

 

PC-7A FP      properly obtain informed consent and perform the

procedures that are core to the residency program;

 

PC-8A FP      incorporate the principles and practice of health maintenance, prevention and comprehensive care into each patient care encounter, where appropriate;

 

PC-8B FP      review the biopsychosocial (long term) problem list at

each visit and attend to appropriate longitudinal care

issues;

 

PC-9A FP      assist the patient in arranging for appropriate medical and ancillary referrals that seek to resolve specific issues in the diagnostic or management arenas;

 

PC-9B FP      work together with clerical staff and nursing staff in a

manner that fosters mutual respect and facilitates an

effectively run patient centered practice;

 

 

Medical Knowledge

 

            MK      Residents must demonstrate knowledge about established and evolving biomedical, clinical and cognate sciences and the application of this knowledge to patient care.  Residents are expected to:

 

                        MK-1A FP      appropriately prioritize the probable and potential

                                                diagnoses to ensure that attention is given to the most

                                                likely, most serious and most readily treatable

                                                options;

 

                        MK-2A FP      demonstrate an understanding of pertinent

                                                pathophysiology in making management decisions

                                                using literature and evidence based medicine to

                                                support your decisions;

 

Practice-Based Learning and Improvement

 

            PBLI    Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices.  Residents must be able to:

 

                        PBLI-1A FP   demonstrate knowledge of and participate in practice

                                    review e.g. chart review and practice profiles, participate in practice based quality improvement activities;

 

                        PBLI-2A FP   demonstate the use of the medical literature that is

                                                applicable to their patient’s care;

 

      PBLI-3A FP   demonstrate the ability to obtain and analyze the demographics of their patient panel comparing it with the community;

 

                        PBLI-3B FP   identify the major health issues of the community and

                                                their patient population;

 

                        PBLI-4A FP   develop the ability to critically review a journal article

                                                demonstrating fundamental knowledge of study

                                                design and statistics;

 

                        PBLI-5A FP   demonstrate the ability to perform an online medical

                                                information search;

 

                        PBLI-5B FP   demonstrate proficiency at accessing a computerized

                                                database and applying the information to the

                                                management of the patient;

 

                        PBLI-6A FP  demonstrate the ability to supervise and teach junior

                                                residents, medical students and other members of the

                                                healthcare team;

 

      PBLI-6B FP  demonstrate the ability to teach in both small and large group settings;

 

 

Interpersonal and Communication Skills

 

IC        Residents must be able to demonstrate interpersonal and communication

            skills that result in effective information exchange and teaching with

            patients, their patients’ families and professional associates.  Residents

            are expected to:

 

                        IC-1A FP        develop a trusting, professional relationship that

                              allows them to inquire into and discuss sensitive issues that may impact on the execution of the negotiated management plan;

 

                        IC-2A FP        conduct an interview in a manner consistent with the

                                                values of family practice using appropriate verbal and

                                                nonverbal skills;

 

                        IC-3A FP        work together with other professionals on the health

                                                care team in a manner that fosters mutual respect

                                                and facilitates the effective handling of patient care

                                                 issues;

 

 

            Professionalism

 

PR       Residents must demonstrate a commitment to carrying out professional

            responsibilities, adherence to ethical principles and sensitivity to diverse

            patient population.  Residents are expected to:

 

                        PR-1A FP      demonstrate respect, compassion and integrity in all

                                                doctor-patient encounters;

 

                        PR-1B FP      engage in activities that will foster personal and

                                                professional growth as a physician;

 

                       

                        PR-1C FP      engage in continuing medical education activities that

                                                are influenced by interest, deficiency and need;

 

                        PR-2A FP      at each patient encounter, present yourself and the practice in a manner that will encourage the patient to select you, the practice and family practice in the future;

 

                        PR-2B FP      demonstrate the application of ethical and moral

                                                principles as they pertain to end of life issues, patient

                                                confidentiality and billing practices;

 

                        PR-3A FP      recognize special needs, cultural, age and gender

                                                issues and adapt care to accommodate the

                                                differences;

 

 

            Systems-Based Practice

 

SBP    Residents must demonstrate an awareness of and responsiveness to the

            larger context and system of health care and the ability to effectively call

            on system resources to provide care that is of optimal value.  Residents

            are expected to:

 

                        SBP-1A FP   write referral letters to other physicians that give a

                                                brief, accurate description of the patient, pose a

                                                specific question or request and promote continuity of

                                                care;

 

                        SBP-1B FP   makes appropriate referrals and formulary decisions

                                                based on the patient’s health plan;

 

                        SBP-2A FP   demonstrate an understanding of the different types

                                                of health care delivery systems and the role of the

                                                family physician in each;

 

                        SBP-2B FP   demonstrate a willingness to see same day add-on

                                                patients to preserve continuity and control costly

                                                Urgent Care or Emergency Department visits;

 

                        SBP-3A FP   conduct the visit in a time-efficient and professional

                        manner;

 

                        SBP-3B FP   complete the tasks of the patient care session so that

                                                all necessary duties (including telephone messages,

                                                charting, administrative tasks, patient care) are

                                                accomplished in a timely, organized and professional

                                                manner;

 

                       

                        SBP-3C FP   bill patients fairly and appropriately for services

                                                rendered referring those who need financial

                                                assistance to appropriate business office personnel

                                                and community resources;

 

                        SBP-4A FP   help patients utilize local resources to overcome

                                                obstacles;

 

                        SBP-4B FP   demonstrate involvement in the continuing care of

                                                their patients in the office, hospital and the patient’s

                                                home;

 

                        SBP-5A FP  coordinate care and make appropriate referrals at the

                                                time of discharge from the hospital utilizing other

                                                health care team members and organizations to

                                                provide comprehensive care.