April 2001 • Volume 7 • Number 4
Join in: Reassessment of specialty expands to include all stakeholders
BY JANE STOEVER
The specialty may be ripe for transformation. Consider: Research indicates the public does not understand what a family physician is or can do. In many cases, the scope of family practice is dwindling. Fewer FPs offer maternity services or provide care in hospitals. Other professionals, from homeopaths to nurse practitioners, are giving care formerly considered the domain of FPs.
Many family physicians and medical students are expressing disenchantment with the specialty and its place in the health care delivery system.
The specialty's in flux.
"This is kind of like the ultimate midlife crisis," says AAFP Board Chair Bruce Bagley, M.D., of Albany, N.Y. "We need to ask, 'Where have we been? What have we accomplished? What are we doing next?'
"We need a pause in our development. We need to look at the future and see how to cope with it, how to update our training and our practice and the business of family practice."
The rapidly changing medical environment is challenging all specialties, he adds. "We have to see how family practice can best fit into that environment. And everybody else should be doing the same. It's not just family physicians. Anybody who's sitting out there thinking they can keep doing the same old thing is going to miss the boat ... or the rocket."
Bagley says he expects the health care industry, in the next five years, to go through the same kind of downsizing, the same drive for efficiency and better service, that banking and car manufacturing and service industries outside health care went through about 10 years ago.
To read the signs of the times, each year leaders of the "family of family practice" meet at a Working Party. Participants represent the Academy and six other family medicine organizations. In January 2000, the Working Party decided to convene the Oct. 4 8, 2000, Keystone III gathering, at which 82 attendees and others online grappled with options for the specialty.
The Working Party has decided to expand the specialty's reassessment process.
This January, the Working Party reflected on Keystone III and other discussions within family practice organizations and decided to expand the reassessment to all stakeholders -- FPs, residents and medical students -- and even groups outside the specialty. The Working Party will meet again April 23 at AAFP headquarters to hammer out details of the process, which may include hearings, focus groups and consultants.
"We'll get input at the annual meetings of the family practice organizations," says AAFP Executive Vice President Douglas Henley, M.D. "And we'll do market research to find out what the public expects their family doctors to do for them, not just in a single visit but over a continuum of time."
Groups such as unions and AARP may be asked what they want their family doctor to be like.
"How can our specialty evolve to better meet our patients' needs?" asks Henley. He hopes the answers will improve access to care, quality of care, FPs' reimbursement, their satisfaction with their practices and their communication with patients.
A tall order?
Yes. But see "Changes in the pipeline?" for ways to start filling the order.
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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