In 1971, The Puerto Rican Chapter of General Practitioners changed its name to the American Academy of Family Physicians, which was done to distinguish between non-specialized “generalist” physicians from specialized Family Physicians. Puerto Rico is unique when compared to the mainland United States in that 50.3% of the island’s practicing physicians are non-specialized physicians. Less than 3% of Physicians in
Puerto Rico are Family Medicine Physicians. Our Premise is that the vast majority of the Puerto Rican population do not know the scope of practice of a Family Medicine Physician, in part because of the perception that Family Physicians are non-specialized. On an Island that is in critical shortage of specialized primary care Physicians, like Pediatricians and OBGYN, it is paramount to know that, if indeed, our premise
is correct-That the vast majority of the Puerto Rican population does not know the full scope of practice of a Family Medicine Physicians- Then, the Family Medicine Academy of Puerto Rico along with local and State officials, can perhaps implement an educational campaign on the scope of our practice so as to cover
other specialties that are in critical that are in critical shortage on the island, like pediatricians.The purpose of this survey is to determine the current general knowledge of our specialty in Family Medicine (FM) in Puerto Rico.
We conducted an observational cross-sectional study which consisted of a total of 592 participants. There is no association between knowing a Family Medicine physician and the knowledge that they are specialists. There is a direct relationship of having a higher education level and having a better understanding of Family Medicine with a statistically significant value of P<0.0001.

1. Need for more education on our scope of practice.
2. Increased promotion of our primary care goals in Puerto Rico.
3. Lack of available physicians in PR.

Background: Shared decision making with active patient involvement in healthcare decisions has been promoted over the last decades as a means forward to a more equal, inclusive, and less paternalistic version of medicine. This evolution has also driven design changes in the electronic health record (EHR): patient access to results and notes has been widely included via patient portal systems, although there is great variability in EHR implementation and sharing of information globally. Patient access to the EHR has created many challenges to ethics and professionalism. Could access to results be harmful to patients? Should patients also be able to add information to the record? And how to manage record access for teenagers? The aim of this interactive presentation is to discuss these challenges with the audience and to contribute to the establishment of practical recommendations for sharing information online with patients.
Methods: First, an introductory presentation will present the most common challenges of sharing information via patient portals and an ethical background to these challenges. Second, scenarios based on literature review and experiences of our Working Party members will be discussed in small groups, including cases and experiences brought forward by the audience. Participants will discuss strategies in collaborative, cross-disciplinary group work for a practical approach to bioethics. Lastly, the solutions to the scenarios will be translated to practical ethical recommendations, while critically evaluating the feasibility of designing global guidelines for patient portal use.
Results/outcome: This workshop will allow participants to consider the impact of using a patient portal system and sharing information online with patients more in-depth. Through a focus on ethical and professional challenges in scenario-based analysis, participants will share their own experiences and co-design guidelines for best practice online information sharing. We will specifically focus on their usefulness in different stages of EHR implementation.

1. Understand practical ethical challenges of sharing health information online with patients and the competences and skills expected of a family physician
2. Analyse scenarios of patient portal use to identify and resolve underlying tensions
3. Develop best practice recommendations tailored to their EHR system