Future directions in family medicine: results of a Delphi study.

A Delphi study using a panel of 17 experts in family medicine predicted the characteristics of family medicine in the future to anticipate changes needed in residency education. Proposed new competencies included managing the medical care of the patient, skills in geriatrics, emphasis on health maintenance, health promotion and disease screening, and expertise in computers and data management. Competencies to be de-emphasized included major surgical procedures, specific technical and procedural aspects of hospital care, and obstetrics (except in rural areas). In addition, panelists thought the basic principles and values of family medicine will not change, although there will be emphasis on managed health care, increased care of the elderly, and changes in the professional status of the physician. Curricular changes will require help from other disciplines, new educational settings, and additional faculty and financial resources.