January 2001 • Volume 7 Number 1
Q&A
Richard Roberts, M.D., J.D.'Keep the faith -- good things are coming for family physicians'
Drops in income. The complexities of coding. The frustration of practice in a disintegrating health care system. Difficult transitions. Lives out of balance. Not enough family physicians to go around.
For many FPs these days, meeting the demands of practice is an increasingly tough row to hoe -- that's what President Richard Roberts, M.D., J.D., of Madison, Wis., has been hearing from AAFP members. In this Q&A, Roberts discusses problems facing FPs today, reasons for optimism about the future -- and his ambitious plan for keeping in touch with Academy members and their issues.
What are you hearing -- why are many family physicians saying they are frustrated and discouraged these days?
It's clear that family physicians see the U.S. health care system as a timeworn, cobbled-together patchwork, with themselves stretched like lifelines across the fraying fabric. And many of them are feeling just as worn and frayed as that patchwork system.
The economically robust '90s were good for FPs. Expanding health plans showered us with money to buy our practices and make us their employees. Student interest in the specialty zoomed -- and so did FP incomes.
But then came the managed care backlash. The system's chaotic disintegration accelerated. Student interest in family practice began to decline. Median FP income leveled off -- it even dropped last year. Now, many FPs feel caught in a practice noose that grows only tighter.
What's the impact on you as Academy president?
I broke with tradition. The AAFP president usually leads a new task force to work on one project of interest. Instead, I'm doing three things. I'm shepherding several existing Academy projects to completion and into the hands of FPs to help them. I'm focusing on our members with a message of appreciation and hope. And I'm announcing to America that we need to create a health care system where every American will be able to choose an FP and every American will want one, with the intent of reframing the health care debate and giving our members a sense of pride and responsibility. I want FPs to hold on and keep the faith -- good things are coming their way!
Can you describe some of those AAFP initiatives that make you optimistic?
One is our proposal for health care coverage for all in the United States. Right now, every member can comment on AAFP's proposal -- just go online at http://www.aafp.org/unicov/ or call (800) 944-0000 for a copy (item #R016). The AAFP Board will consider all input and submit a plan to the Congress of Delegates next fall.
Beginning next month, the Academy will communicate the value of family practice to the public and policy-makers with an exciting Public Awareness Campaign. This three-year, $3.5 million effort will include ads in USA Today and The Washington Post, as well as support of National Public Radio's Morning Edition and All Things Considered. Stay tuned for campaign specifics in the February FP Report.
In addition, our nearly $8 million investment in family practice research is bearing fruit. You'll soon see a growing volume of literature demonstrating the high-quality, cost-effective, patient-centered care that FPs provide. Our policy center in Washington will translate those findings into conclusions that even politicians and payers can understand!
And then there's the Practice Quality Enhancement Program, as well as AAFP's involvement in IDCOP, the Idealized Design of Clinical Office Practices initiative. The Academy also is working to put FPs on the cutting edge of information technology. And finally, the Academy is moving to an evidence-based system for classifying CME clinical content, which will ultimately help FPs provide the most scientifically valid care for their patients.
You've also committed yourself to an ambitious effort to call one member a day during your presidency. Can you give more details?
It's my Direct Dialogue campaign. I want to stay in touch with rank-and-file members and be aware of the issues they face and how the Academy could serve them better. In the Direct Dialogues I've had so far, a few members have said things are going well -- but many have said they're stressed and discouraged. Their concerns are across the board, from economic credentialing to Medicare fraud, from life balance to a family physician shortage.
I tell them not to give up, because all these good things are coming from the Academy -- things that will make our practices more effective and efficient and, most important, things that will help our patients and in turn help us to enjoy more of our moments with those patients. Because when all is said and done, the health of our patients remains our greatest concern, and our relationships with them remain our greatest source of professional satisfaction and strength.
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