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Member Research & Reports

Member Research & Reports

Kentucky: Investigating the Scope of Practice for Rural vs. Urban Family Physicians

A pair of reports from the Rural and Underserved Health Research Center  at the University of Kentucky College of Public Health shed new light on the scope of practice of rural family physicians.

Describing the impetus for the first report, “Rural Family Physicians Have a Broader Scope of Practice than Urban Family Physicians,” investigators Dr. Lars Peterson and Dr. Bo Fang note that at present “little is known about whether rural family physicians provide a broader scope of practice, defined as the range of clinical and procedural services that they provide, than metropolitan family physicians.”

To study the scope of practice of rural versus urban family physicians, the investigators used data from 18,846 family physicians, and examined variations in the provision of 21 clinical services (e.g., inpatient care, home visits, and obstetrics) and 18 procedural services (e.g., prenatal ultrasound, endoscopy, and office skin procedures) across metropolitan, large rural, small rural, and frontier areas. They found that the percentage of family physicians providing each type of clinical and procedural service rises with increasing rurality.

The second report, “Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice,” resulted from an investigation of the impact of the Patient Centered Medical Home (PCMH) model of care. PCMH is intended to provide accessible and comprehensive care, but to date little is known about how practicing in a PCMH is associated with rural family physicians’ scope of practice.

Using data from 18,846 family physicians nationally, investigators found that rural family physicians working in PCMH practices generally provide a wider scope of clinical and procedural services than those not working in PCMH practices.

The Rural and Underserved Health Research Center (RUHRC) brings together a team of rural health services and policy experts from across the University of Kentucky. Dr. Ty Borders, Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy at the UK College of Public Health, is director.

The RUHRC aims to advance understanding of effective means of organizing health services, facilitating access, and improving population health in rural America, especially in areas with low median household incomes, high poverty and unemployment rates, and low educational levels. The RUHRC disseminates research findings to inform health policy makers, health system managers, and providers about how to better organize and deliver health services, with the ultimate goal of reducing inequities in care and improving population health in rural communities.