January 2002 • Volume 8 • Number 1
'Our touch really matters to our patients'
WARREN JONES, M.D.
Today's family physicians face tough challenges -- including ones brought on by the heightened concern about terrorism. In this interview, AAFP President Warren Jones, M.D., of Ridgeland, Miss., talks about those challenges, about the FP's role as the "sentinel family physician," and about the strengths FPs and the Academy bring to the medical profession.
What key issues face family physicians today?
Let me note a few concerns.
- * Family physicians wrestle with Medicare and Medicaid reimbursement issues, regulatory burdens and malpractice coverage. Also, we need to increase the "match" between our family practice residencies and residency candidates.
- * The cultural landscape in America is changing dramatically, with many more minorities than before. We need to help our patients bridge the health literacy gap and better understand how they can improve their health.
- * We ourselves need to keep bridging the digital divide. Many patients and health professionals are becoming more comfortable with technology, more creative with it, and the results are exciting. For example, in the last 12 years, in the Navy, I only occasionally wrote a prescription by hand.
- * Also, getting health coverage for all Americans is critical. Our AAFP plan, "Assuring Health Care Coverage for All," can be the means for solving the crisis of the uninsured and underinsured in our country.
What do patients look for in a family physician?
Compassion, competency and effective communication.
Our touch really matters to our patients. I have often asked people who go to other family physicians, "What do you think about your family doctor?" They've repeatedly said their family doctor touched their lives.
Our health care system is broken. Lots of times, patients receive compassion and down-to-earth explanations from family doctors but not from other doctors. When people don't care and don't communicate, it makes traversing the broken health care system much more difficult.
You've called on members to be the nation's sentinel family physicians in the war on terrorism. What does that mean?
Our Academy is gathering resources (see "Academy Steps Up Its Role as Bioterrorism Iformation Resource") to help us:
- recognize terrorist threats and events without overreacting,
- help patients recognize these threats without overreacting,
- treat our patients when appropriate, and
- know what, when and where to report.
Current disaster plans -- for floods, earthquakes, fires -- focus on hospital care. The dollars are for inpatient care, the training is for hospital-based professionals, the equipment is for hospitals.
So who will identify the patient who comes to the doctor's office with an unusual set of symptoms? Family doctors need to be able to tell public health authorities, "I don't usually see these symptoms at this time of year." We need to make sure family physicians help plan for disasters and are interwoven into response strategies, community by community.
You've said caring for adolescents and preventing teen violence are especially important to you. Why?
A lot of people are combating gun violence and, specifically, violence among teens. That's important, but even more important is realizing that the violence erupts when people don't know how to eliminate a conflict at its lowest level. The conflict finally leads to a major injury, homicide or suicide.
I had 11 brothers and sisters. My dad moved away from our home in New Orleans when I was 5. He never lived far away, but he never lived with us again. In large measure, I think his leaving was due to our family's inability to resolve conflicts early.
As I reached my mid-teens, I became a juvenile delinquent and ended up almost going to jail. Were it not for some people who saw a future in me, I would have been a statistic. Eventually, I learned conflict resolution skills; that helped turn me around.
I'd like family physicians who are helping parents or youngsters resolve conflicts to contact this newspaper at fpreport@aafp.org or (800) 274-2237, Ext. 5216, and share techniques for de-escalating conflict.
What does the complexion of the AAFP Board say to America?
We are black, brown, white, women, men, young, old, rural and urban. I -- and some other Board members -- can make sure that when we talk about issues, we don't miss the inner-city component, the poor, the un-derrepresented. The woman at our table who is brown can make sure we don't overlook migrant workers and immigrants. And so on.
What that says to America is that our organization addresses concerns of the full scope of our population -- rich, poor, people of different colors, of many backgrounds. Our Academy has voted into leadership people who've walked miles in different kinds of shoes.
Do FPs sense how important they are to their communities?
When family physicians are sick, retiring, shifting from full-time to less-time practice or moving to another town, patients come out of the woodwork and say, "We miss you! We love you!"
During our typical years of practice, however, many patients thank us with a smile or comment we might not heed. Occasionally, a patient might bring in a cupcake and say, "I know you've got a sweet tooth." In the bayou, where people go shrimping, it might be a little freezer bag of shrimp. What a measure of love!
The Academy is working hard to minimize the irritants that hinder us -- coding issues, reimbursement problems, legislative boondoggles. It's up to us in our practices to focus less on these hassles and reclaim the joy of our specialty.
FP Report is published by the AAFP News Department.
Copyright © 2002 by American Academy of Family Physicians.
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