Perspectives on teaching among community-based family physicians

Background: Clinical education increasingly occurs in ambulatory and primary-care practices. Physicians face increased demands for clinical productivity. Purpose: To explore whether community-based family physicians' perceptions of problems in primary-care practice affect their attitudes toward teaching. Methods: Using the national databases of the American Academy of Family Physicians, we identified a sample of family physicians who teach but are not based at academic health centers. These 80 family physicians were surveyed by telephone about their careers and their reaching. Results: The response rate was 61%. Respondents identified several problematic aspects of medical practice that may have a negative impact on teaching: administrative demands, decreasing autonomy, diminished control over conditions of practice, concern about future income, and increased productivity demands Over three fourths of the respondents (77.5%) were concerned that increasing the amount of teaching they do would decrease their incomes. Nonetheless, they reported spending a significant proportion of their time teaching(7.4%). Only 6.3% of the respondents felt that teaching is more a burden than a pleasure; 46.3% felt that reaching is more a pleasure than a burden; and 47.5% felt that it is a balance between the two. There were no significant relations between the degree to which the different aspects of medical practice were perceived to be problems and the percentage of time spent teaching, the perception of teaching as a burden, or concern that increased teaching would decrease income. Conclusions: Despite widespread concern among these practitioners about problems of practice and that more time spent teaching may threaten income, they continue to express pleasure in teaching.