November 2000 • Volume 6 Number 11
'Keystone III' sparks rich discussion on-site and online
BY SARAH THOMAS
What was it like -- "Keystone III," the Oct. 4-8 family practice think tank in the mountains of Colorado? Did it accomplish what it set out to do? The answer is yes, if participants' comments are any measure.
Keystone's diverse attendees assessed the specialty's present and envisioned its future. Some faces of Keystone, clockwise from top left: practicing FP David Loxterkamp, M.D., Belfast, Maine; academician Rosemary Stevens, Ph.D., Philadelphia; resident Erika Bliss, M.D., Seattle; new practicing physician Terrence Steyer, M.D., Charleston, S.C.; solo FP Regina Benjamin, M.D., M.B.A., Bayou La Batre, Ala.; and family practice pioneer Eugene Farley Jr., M.D., M.P.H., Verona, Wis.
Keystone III aimed to "examine the soul of the discipline of family medicine" -- to take stock of the present and grapple with the future of family practice. To begin the specialty's evolution to the next level, if you will.
To get a sense of the discussion, check out these comments:
"A regenerating experience."
"I found the sessions stimulating, challenging, sometimes frustrating and often reassuring."
"Intense."
"What next?"
"I'm thinking about issues like our social contract, moral authority -- I wasn't before this conference."
"I feel this meeting will be a turning point, in ways yet to be determined, in my career."
"Yes, people are listening on the Web. This technology absolutely amazes me. Thank you so much for opening the door -- I mean, the information highway."
"This is a great idea -- it allows me to participate from the comfort of my own home."
These are just a few of the comments from the 82 conference attendees and from online participants who accessed the live webcasts of the conference.
The event followed in the footsteps of Keystone I and II, held in 1984 and 1988 at Keystone, Colo.
Gayle Stephens, M.D., of Birmingham, Ala., an early pioneer of the specialty, created the early Keystones as times of meditation in the mountains -- times for family physicians to stimulate each other's thinking, provoke each other, inspire each other. Stephens planned this Keystone, too, along with John Frye, M.D., professor and chair of the family medicine department, University of Wisconsin-Madison; Robert Graham, M.D., of Bethesda, Md., former AAFP executive vice president; and Larry Green, M.D., director of The Robert Graham Center: Policy Studies in Family Practice and Primary Care in Washington.
While participants' opinions often clashed, the end result was unity. Embodiment of that unity: conference planner Gayle Stephens, M.D., right, of Birmingham, Ala., walks arm in arm with Kent Smith, M.D., of Cleveland to discuss a Keystone session.
Keystone III drew together 82 attendees and even more online participants to discuss "next steps" for family practice.
Attendees were diverse -- academics, practicing FPs, men, women, minorities. And they represented three "generations" of family physicians, from early leaders to those joining the specialty in the '90s.
Three participants were assigned the task of summarizing the four days of intense discussion on the final day.
- "Something special has happened here," reported Donald Ransom, Ph.D., professor of family and community medicine at the University of California-San Francisco and clinical integration and quality director at Sutter Medical Group of the Redwoods in Santa Rosa. "Keystone III was like a giant projection screen, with several themes emerging. Those themes addressed the needs, wants and desires of the new generation of family physicians, as well as the need for us all to reaffirm our professional identity and role at the center of the changing health care delivery system."
- "Over the past few days, we've talked about leaving some 'sacred cows' behind -- and I agree," said Regina Benjamin, M.D., M.B.A., a solo family physician in Bayou La Batre, Ala. "But there are some 'sacred cows' that should remain so: Each life is sacred, putting patients before self is sacred, the patient/physician relationship is sacred, professionalism is sacred and ensuring quality in our health care system is sacred."
- "Most of our discussions were dichotomous, demonstrating the tension between the academic world and community practice, literary or narrative thinking and scientific thinking, pragmatism and idealism, public interest and professional interest," said John Saultz, M.D., chair of the family medicine department and assistant dean of primary care at Oregon Health Sciences University School of Medicine in Portland. But the end result was unity, he said: "Today, we leave as one."
No action items were identified during the conference -- which is exactly what was intended.
"What we planned -- what we hoped for -- was a rich dialogue where we could come together for an ongoing discussion of multiple topics at various levels. The degree of our success will be measured by our ability to maintain the discourse," said Green. Ultimately, that discourse should lead to consensus on a vision for the future of family practice, he said.
Discussion papers presented during the conference will be published in the April 2001 issue of the Society of Teachers of Family Medicine's journal, Family Medicine, with complete proceedings to follow later in the year. You also can find the discussion papers archived at http://www.aafp.org/keystone.
The meeting was sponsored by the AAFP, AAFP Foundation, American Board of Family Practice, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group and STFM.
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
FP Report | Headlines |AAFP Home | Search
