BACKGROUND: Given that mental health problems in adolescence may have lifelong impacts, the role of primary care physicians (PCPs) in identifying and managing these issues is important. Artificial Intelligence (AI) may offer solutions to the current challenges involved in mental health care. We therefore explored PCPs\' challenges in addressing adolescents\' mental health, along with their attitudes towards using AI to assist them in their tasks.
METHODS: We used purposeful sampling to recruit PCPs for a virtual Focus Group (FG). The virtual FG lasted 75 minutes and was moderated by two facilitators. A life transcription was produced by an online meeting software. Transcribed data was cleaned, followed by a priori and inductive coding and thematic analysis.
RESULTS: We reached out to 35 potential participants via email. Seven agreed to participate, and ultimately four took part in the FG. PCPs perceived that AI systems have the potential to be cost-effective, credible, and useful in collecting large amounts of patients\' data, and relatively credible. They envisioned AI assisting with tasks such as diagnoses and establishing treatment plans. However, they feared that reliance on AI might result in a loss of clinical competency. PCPs wanted AI systems to be user-friendly, and they were willing to assist in achieving this goal if it was within their scope of practice and they were compensated for their contribution. They stressed a need for regulatory bodies to deal with medicolegal and ethical aspects of AI and clear guidelines to reduce or eliminate the potential of patient harm.
CONCLUSIONS: This study provides the groundwork for assessing PCPs\' perceptions of AI systems\' features and characteristics, potential applications, possible negative aspects, and requirements for using them. A future study of adolescents\' perspectives on integrating AI into mental healthcare might contribute a fuller understanding of the potential of AI for this population.

The \'Mastering your Fellowship\' series provides examples of the question format encountered in the written and clinical examinations for the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series is aimed at helping family medicine registrars prepare for this examination. Model answers are available online.

BACKGROUND:  Family medicine has trained specialist family physicians in South Africa since 2008, but not investigated their career pathways. The study aimed to determine the career pathways of newly qualified family physicians between 2008 and 2022.
METHODS:  A cross-sectional descriptive survey of all 186 family physicians via an electronic questionnaire.
RESULTS:  Response rate was 44.6% (83/186). Overall, 9.6% emigrated, 10.8% were no longer practising, and 79.5% were still practising in South Africa. Of the latter, 14.5% were in the private sector, 55.4% in the public sector and 9.6% in both. Of those in the public sector, 33.7% were in specialist family physician posts, 12% in medical officer posts, 4.8% in managerial positions and 4.8% in academic positions. Issues relating to safety and security were important to those working in both sectors and relationships with colleagues in the clinical team, to those in the public sector. Overall, participants practised near or within their province of training and were not equitably distributed.
CONCLUSIONS:  Only a third of graduates were in specialist family physician posts in the public sector. Attention needs to be given to retaining more graduates in such posts to achieve the goals of the national position paper. The proportion in the private sector was lower than expected. The reasons for no longer practising medicine should be further explored.Contribution: This is the first study on the career pathways of family physicians in South Africa since the new speciality was created. Understanding these pathways will assist with human resources for health planning.

Chronic subdural hematoma (CSDH) is a great mimicker. It should be considered in anyone presenting with chronic headaches that show postural variation. Parkinsonism following CSDH, while known, is only rarely reported in the literature. Hyponatremia, rapid correction of hyponatremia, medications, and mechanical pressure are thought to be risk factors. Here, we report a case of a 61-year-old male diagnosed with bilateral CSDH managed by craniotomy and clot evacuation who developed parkinsonism. We share several learnings (clinical pearls) that emerged from the close collaboration and co-learning curve between a family physician and physiotherapist involved in home-based rehabilitation. In conclusion, while managing the postoperative course of patients with CSDH, clinicians should maintain a high index of suspicion for parkinsonism. Early recognition and appropriate management with syndopa with supportive physiotherapy results in significant improvement of function and quality of life. Notably, parkinsonism following SDH is transient and nonprogressive and may not require lifelong therapy.

Dr. Prakash Chand (PC) Bhatla MBBS was one of the illustrious past presidents (1975-76) of Indian Medical Association (IMA). He was a General Practitioner by vocation and a towering professional leader. He made an immense contribution to the discipline of Family Medicine - the academic discipline, medical specialty, and the knowledge domain of Family Physicians/Family Doctors within India as well as the global level. He was a brilliant human being and professional par excellence. He was probably one of the greatest leaders of the medical profession in India and a rightful successor to Dr BC Roy\'s legacy. As a rare achievement, he received the Dr BC Roy National Award from the President of India twice. He received this prestigious recognition award in 1977 for socio-medical relief in India and again in 1982 for the promotion of Specialty of General Practice. He founded IMA CGP (Indian Medical College of General Practitioners), and his foundational work led to the recognition of Family Medicine as a specialty in India. Due to his efforts, Family Medicine was included in the list of recognized specialties by the National Board of Examinations (NBE) as well by the Medical Council of India (MCI). His contribution to medicine at a global level is also remarkable. He is also considered one of the founding forefathers of WONCA - World Organization of Family Doctors. He was associated with the foundation process of WONCA from the beginning (1964). The International Liaison Committee organized the first World meeting of General Practice in Montreal (Canada) in 1964 and the second meeting in Salsburg in 1966. Dr Bhatla was the convenor of the Third World Conference on General Practice in New Delhi, India, in 1968. A global representative body of Family Medicine/General Practice was launched in 1972 in Melbourne, Australia. Due to contribution to WONCA, he was elected for the first ever WONCA fellowship, the most prestigious global Family Medicine award. He was contemporary to other world leaders of Family Medicine and Primary Care such as Ian McWhinney and Barbara Starfeild. He is rightfully recognized and remembered as Father of Family Medicine. Dr Bhatla\'s intellectual, professional, and administrative contribution laid down the sound background for the foundation of a Specialty body of Family Medicine in India called the Academy of Family Physicians of India. Life and work of Dr PC Bhatla continues to inspire family doctors, family physicians, general practitioners, and Family Medicine specialists across India, South Asia, and the World in the 21st century.

BACKGROUND: During the COVID-19 pandemic, family physicians (FPs) served as the the initial point of contact for patients potentially infected with the virus, necessitating frequent updates to treatment protocols. However, practices also faced organizational challenges in providing care to other patients who also needed their medical attention. The pressure on FPs increased and affected their well-being. The international PRICOV-19 study, titled \"Primary care in times of COVID-19 pandemic,\" investigated how FPs functioned during the COVID-19 pandemic. This article examines the correlation between various organizational and structural COVID-19-related variables and the well-being of FPs in Slovenia.
METHODS: Between October 2020 and January 2021, we conducted an online cross-sectional survey. The questionnaire was distributed to 1040 Slovenian FPs and 218 family medicine (FM) trainees. Part of the questionnaire assessed the cooperation and well-being of FPs. The Mayo Clinic Well-being Index was used for the assessment. FP\'s well-being was also assessed descriptively by asking open-ended questions about maintaining mental health during the pandemic. Potential factors associated with FPs\' well-being were identified using a multivariate linear regression method.
RESULTS: The final sample comprised 191 participants (response rate 14.1%). The mean value ± standard deviation of the Mayo Well-being Index was 3.3 ± 2.6 points. The FPs with the poorest well-being had 5-15 years of work experience and worked in a practice where work could not be distributed in the absence of a co-worker without compromising the well-being of colleagues. Physical activity was identified as the most common method of maintaining mental health among FPs.
CONCLUSIONS: The results of the study suggest that targeted interventions are needed to support FPs mid-career, increase resilience in practice, promote strong team dynamics, and prioritise physical activity in healthcare. Addressing these aspects can contribute to the well-being of individual FPs and the overall health of the healthcare workers.

OBJECTIVE: Procedures are manual technical skills clinicians perform for their patients. Family physicians (FPs) acquire these skills during residency; most are undertaken in outpatient settings. We performed a retrospective observational cohort study to describe the extent to which FPs perform the core procedures recommended by the Council of Academic Family Medicine (CAFM) and how this might have changed over time.
METHODS: The CAFM recommended a list of procedures all FP residents should perform competently after graduation. We modified this list for Medicare beneficiaries to enable matching with Current Procedural Terminology codes. We probed Medicare Part B databases for modified CAFM procedure claims submitted by FPs in 2021 and how these claims changed from 2014 to 2021.
RESULTS: In 2021, there were 904,278 modified CAFM procedures filed by 9,410 FPs in the outpatient setting. All procedures were clustered with respect to organ system (eg, musculoskeletal, skin, pulmonary). Beginning in 2014 and continuously through 2021, there was a 33% decrease in outpatient procedures filed and a 36% decrease in the number of FPs filing them.
CONCLUSIONS: Office-based procedures are integral to a primary care physician\'s role, although the activity is rarely analyzed. At a time when the Medicare population is growing, the number of available FPs and the number of procedures they perform are not. This decrease might result from the changing scope of FP practice, new referral patterns, task shifting, and/or increased delegation to physician associates and nurse practitioners.

OBJECTIVE: This study examined demographic, practice, and area-level characteristics associated with family physicians\' (FP) provision of maternity care.
METHODS: Using the American Board of Family Medicine Certification examination application survey data, we investigated the relationship between FPs\' maternity care service provision and (1) demographic (gender, years in practice, race/ethnicity), (2) practice characteristics (size, ownership, rurality), and (3) county-level factors (percentage of reproductive-age women, the number of obstetrician-gynecologists (OBGYNs) and certified nurse midwives (CNMs) per 100,000 reproductive-age women). We performed summary statistics and multivariate logistic regression analyses.
RESULTS: Of the 59,903 FPs in the sample, 7.5% provided maternity care. FPs practicing in rural were 2.5 times more likely to provide maternity care than those practicing in urban areas. FPs in academic (odds ratio [OR] 4.6, 95% confidence interval [CI] 4.1-5.1) and safety-net settings (OR 1.9, 1.7-2.1) had greater odds of providing maternity care. FPs in the bottom quintile with no or fewer OBGYNs and CNMs had a higher likelihood of maternity care provision (OR 2.1, 1.8-2.3) than those in the top quintile, with more OBGYNs and CNMs.
CONCLUSIONS: FPs in high-needs areas, such as rural and safety net settings, and areas with fewer CNMs or OBGYNs are more likely to provide maternity care, demonstrating the importance of FPs in meeting the needs of women with limited maternity care access. Our study findings highlight the importance of considering the contributions of FPs to maternity care as the organizations prioritize resource allocation to areas of highest need.

BACKGROUND: Community Paramedicine (CP) is an emerging model of care addressing health problems through non-emergency services. Little evidence exists examining the integration of an app for improved patient, CP, and family physician (FP) communication. This study investigated FP perspectives on the impact of the Community Paramedicine at Clinic (CP@clinic) program on providing patient care and the feasibility and value of a novel \"My Care Plan App\" (myCP app).
METHODS: This retrospective mixed-methods study included an online survey and phone interviews to elucidate FPs \' perspectives on the CP@clinic program and the myCP app, respectively, between January 2021 and May 2021. FPs with patients in the CP@clinic program were recruited to participate. Survey responses were summarized using descriptive statistics, and audio recordings from the interviews thematically analyzed.
RESULTS: Thirty-eight FPs completed the survey and 10 FPs completed the phone interviews. 60.5% and 52.6% of FPs reported that the CP@clinic program improved their ability to further screen and diagnose patients for hypertension, respectively (in addition to their regular screening practices). The themes that emerged in the phone interviews were grouped into three topics: app benefits, drawbacks, and integration within practice. Overall, FPs described the myCP app as user-friendly and useful to improve interprofessional communication with CPs.
CONCLUSIONS: CP@clinic helped family physicians to screen and monitor chronic disease. The myCP app can impact health service delivery by closing the gap between primary, community, and emergency care through an eHealth information-sharing platform.

The singular label of \"Asian\" obscures socioeconomic differences between Asian ethnic groups that affect matriculation into the field of medicine. Using data from American Board of Family Medicine Examination candidates in 2023, we found that compared to the US population, among Asian-American family physicians, Indians were present at higher rates, while Chinese and Filipinos were underrepresented, suggesting the importance of continued disaggregation of Asian ethnicities in medicine.