We used American Board of Family Medicine (ABFM) data of questionnaire respondents from January 1, 2016 to December 31, 2021 to describe the trends and current state of family physician demographics. This data includes self-reported information regarding race/ethnicity, scope of practice, ownership, income/payment models and physician well-being. These cross-sectional data points can be used to characterize the family medicine field at specific points in time, as well as allowing for the identification of trends and similarities between different cohorts.

Data Sources

ABFM Continuous Certification Candidate Demographic Report

The ABFM Continuous Certification Candidate Demographic Report is derived from a standardized questionnaire mandatory to practicing physicians who choose to continue or regain their ABFM certification.^1,2 The data was collected during the process of registration for the examination, 3-4 months prior to the actual date of the examination. In addition, there are five rotating question sets to sample physicians on topics relating to meaningful use of electronic health records, patient-centered medical home features, types of payment their practices accept, and procedures performed, physician wellness and burnout.¹ These rotating sets are distributed in a round-robin style, where recipients are only responsible for answering their assigned set to reduce questionnaire burden. In addition to the rotating question set between respondents, some questionnaire questions were only provided depending on a certain answer to a prior question. For questions regarding practice, if a physician had previously indicated they were not practicing, these questions were omitted. Thus, the sample population (N) differed throughout survey questions. Of note, the 2020 and 2021 continuing certification examination cohorts were smaller than other years due to changes in the certification program 10 years prior. The 2020 and 2021 continuing certification examination cohorts were smaller than other years due to changes in the certification program 10 years prior.

ABFM Initial Certification Candidate Demographic Report

The ABFM Initial Certification Candidate Demographic Report is derived from a standardized questionnaire mandatory to family physicians who are seeking ABFM initial certification. The data was collected during the process of registration for the examination, 3-4 months prior to the actual date of the examination. For most candidates, this is midway through their last year of family medicine residency. Some questionnaire questions were only provided depending on a certain answer to a prior question; thus, the N differed throughout survey questions.

ABFM Graduate Survey Report

The ABFM Graduate Survey Report is derived from a standardized questionnaire given to ABFM Diplomates three years following residency graduation.³ Each year the survey opens January to December; for example, the 2021 survey contains information regarding those who completed residency in 2018. The surveys utilized in this Factbook are from 2016-2021, providing a snapshot of physicians from 2013-2018 residency graduates. This survey is voluntary; thus, survey responses do not represent the entire sample of eligible respondents. Some questionnaire questions were only provided depending on a certain answer to a prior question resulting in different sample populations (N) throughout survey questions.

Limitations and Caveats

While our data includes a large cohort of practicing family physicians in the United States, only those certified by ABFM are included. Previous studies estimate that the total family physician population that is certified by ABFM is 82-85%.^4,5 This Factbook does not represent the entirety of U.S. family physicians but self-reported data extrapolated from this large sample population does serve as a crucial contributor towards understanding family medicine practice and trends. Furthermore, some ABFM data is acquired via rotating cross-sectional surveys (see Data Sources section above). This can only provide a snapshot of candidates at a given point in time. Due to the COVID-19 pandemic, the deadline of the 2021 ABFM Graduate Survey Report was extended into 2022. The data extracted for this Factbook only includes respondents from 2016 through December 31, 2021, thus not representing the entirety of 2021 Graduate Survey Report respondents.

Methods References

1. Peterson LE, Fang B, Phillips RL, Avant R, Puffer JC. The American Board of Family Medicine’s Data Collection Method for Tracking Their Specialty. Journal of the American Board of Family Medicine. 2019;32(1):89-95. doi:10.3122/jabfm.2019.01.180138

2. Cattoi R. American Board of Family Medicine Introduces Important Enhancements to Maintenance of Certification for Family Physicians. Journal of the American Board of Family Medicine. 2011;24(3):334. doi:10.3122/jabfm.2011.03.110042

3. American Board of Family Medicine. National Family Medicine Graduate Survey Reports. American Board of Family Medicine. Accessed July 14, 2022. https://www.theabfm.org/research/national-family-medicine-residency-graduate-reports

4. Peabody MR, Young A, Peterson LE, O’Neil TR, Pei X, Arnhart K, Chaudhry HJ, Puffer J. The Relationship Between Board Certification and Disciplinary Actions Against Board-Eligible Family Physicians. Academic Medicine. 2019;9(6):847-852. doi:10.1097/ACM.0000000000002650

5. Dai M, Peterson LE. Characteristics of Family Medicine Residency Graduates, 1994-2017: An Update. Annals of Family Medicine. 2020;18(4):370-373. doi:10.1370/afm.2535