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Trends in patient encounters: implications for family medicine clerkships.

BACKGROUND AND OBJECTIVES
Adequate and equivalent clinical experience is related to the number and diagnoses of patients encountered and should provide students with experiences similar to community practice. This study compares the distribution of diagnoses family medicine clerkship students encountered at a Midwest medical school during 2009-2011 with both 1997-1999 data and the 2010 National Ambulatory Medical Care Survey (NAMCS) samples of family physicians and all physicians.


METHODS
Electronically submitted encounter data (2009-2011) were compared to logbook data (1997-1999) and to the 2010 NAMCS data listing primary diagnoses at office visits in the United States by major disease category.


RESULTS
Of the 15 diagnoses with ≥150 encounters, seven increased and eight decreased between the two time periods. The relative percent ratio of clerkship diagnoses distribution to the NAMCS family physician distribution revealed that diagnoses ratios were ≤100% in eight categories (clerkship experiences<national) and greater than the national distribution in seven categories.


CONCLUSIONS
As medical care services and settings change, documenting comprehensive clinical experiences will be valuable to respond to changes in patient presentations in family physician offices, both locally and nationally. Patient encounter data evaluations should be used to ensure students' clinical experiences are adequate, equivalent, and reflective of community practice. Continuous assessment of student experiences is essential due to shifts in prevalence, practice characteristics, and changes in patient preferences.