Role of family medicine on health systems in the Americas: scoping review

Objective To synthesise the available evidence on the reported role of family physicians in health systems in the Americas. Design A scoping review was conducted following the methodology of the Joanna Briggs Institute. The results were grouped into thematic categories and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Eligibility criteria Peer-reviewed articles and relevant grey literature published between 2010 and 2025 examining the role or impact of family physicians within health systems in the Americas. Studies that did not explicitly address family physicians or lacked accessible full text were excluded. Information sources A comprehensive search was performed in PubMed, Scopus, Embase, LILACS and the Virtual Health Library (BIREME). Grey literature was identified through institutional repositories, policy reports and targeted searches of official websites. Results Of 1397 records identified, 34 studies met the inclusion criteria. Most publications were produced between 2013 and 2024 and represented diverse health system contexts across the region. The attributes most frequently associated with family physicians were comprehensiveness, accessibility, continuity of care, coordination and family and community orientation. Across multiple national settings, the included studies consistently reported that stronger integration of family physicians within primary healthcare systems was associated with improved access to services, greater continuity of care, more efficient coordination across levels of care and a more rational use of diagnostic and therapeutic resources. Conclusions Family physicians appear to represent an important component of effective primary healthcare systems in the Americas. Their integration within health services is associated with improved service accessibility, greater care continuity and more efficient resource use. Strengthening family medicine workforce capacity and its institutional role may contribute to more equitable, resilient and sustainable health systems across the region. Trial registration number Protocol registered and available on this OSF project https://osf.io/pnf2b/ .