Fam Pract Manag. 2003 Jan;10(1):11.
In 1996, I was selected as FPM’s medical editor to replace Joseph Scherger, MD, MPH, upon his election to the AAFP board of directors. In an early editorial, I shared my vision of optimal family practice.1 In that ideal health system, “Dr. Susan Sanchez” continuously monitored the health status of her entire patient population aided by a computerized medical record system. She documented that her patients received the recommended preventive, acute and chronic care services. Patient satisfaction survey data documented that her care was highly valued. The health system helped coordinate her patients’ care. The health plan rewarded the family doctor for medical excellence.
Some essential elements characterized this optimal health system. First, the family doctor took care of her entire population of patients, not just those who appeared at the office. Second, an office practice built upon an electronic medical record system facilitated population-based care. Third, the health system helped her keep watch over her patient population. Finally, the payer rewarded her for medical excellence. In this office practice of the future, she maintained the close personal relationships with patients and families that are the soul of our specialty while documenting that their patients received state-of-the-art care and service.
With this destination in mind, FPM’s mission has been to give family physicians the tools for effective practice. We defined an FPM curriculum to serve as our guide; published a plethora of articles and reviews on electronic medical record systems; created “The FPM Toolbox” of useful resources; and developed an FPM Practice Self-Test to help family doctors map out their individual journeys.2
The “early adapters” among us have already begun to transform their offices with computerized systems, open-access scheduling and streamlined processes. But most family physicians have been frustrated by a dysfunctional health system. As a result, family medicine has been forced largely to make this journey alone.
While continuing to advocate for the most favorable health system conditions for primary care, our specialty is appropriately turning inward at this stage to help more family doctors reach this destination. The Future of Family Medicine Project is “developing a strategy to transform and renew the specialty of family practice to meet the needs of people and society in a changing environment.”3
As FPM enters its tenth year, this issue marks my last as FPM’s medical editor and the end of a 13-year association with AAFP publications, having served as associate medical editor of American Family Physician from 1989 to 1995. I have been truly blessed to work with FPM’s creative editor-in-chief, Bob Edsall, and his dedicated and competent staff. I am also grateful for the vision, energy and enthusiasm of the family physicians on FPM’s board of editors.
Continuing the journey
It is comforting that most family physicians consider FPM a valuable guide. Our readership and reading thoroughness have increased steadily since we began our surveys. Our FPM readers are dedicated to its content. I am grateful to you, our readers, for your positive feedback when we met your needs and your constructive suggestions for improving our content.
Our collective journey toward medical excellence continues. I am fortunate to be working for a nonprofit health system that is dedicated and striving to help family doctors reach their destination. I look forward to receiving the next issue of FPM to help guide me along the way.
Dr. Rivo, FPM’s medical editor, is regional medical director and medical advisor for disease management at AvMed Health Plan in Miami. He is also volunteer clinical professor of family medicine at the University of Miami, and editor of Wonca News, the bimonthly publication of the World Organization of Family Doctors.
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1. Rivo ML. Family practice in the new millennium: from health care to health improvement. Fam Pract Manage. June 1997:17–18.
2. Rivo ML. Improving your practice through the FPM self-test. Fam Pract Manage. February 2001:11.
3. Future of Family Medicine Project. See www.futurefamilymed.org.
Copyright © 2003 by the American Academy of Family Physicians.
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