FPs air concerns, leaders share strategies at town hall meeting -- FP Report

FPs air concerns, leaders share strategies at town hall meeting

WEB EXTRA!

BY CINDY BORGMEYER

The field of discussion was wide open at an Oct. 14 town hall meeting in the convention center, where participants fired questions at Academy leaders about family medicine issues past, present and -- most of all -- future.

The stated topics for the town hall gathering were the Future of Family Medicine report; medical liability; and the American Board of Family Practice's Maintenance of Certification Program for Family Physicians, or MC-FP.

AAFP officers leading the discussion got all that and more. Some highlights:

Karen Wakefield, M.D., of Palestine, Ill., was one of several FPs to raise the issue of MC-FP. Some stated flatly they would not recertify. Among concerns Wakefield and others cited were a perceived increased cost for completing a more involved new recertification process.
When you break it down, though, said AAFP EVP Douglas Henley, M.D., FPs can actually save on their recertification costs, thanks to the ABFP's continuing expansion of the number of testing sites around the country. The savings would come even with the added cost -- $50 -- for each of the six self-assessment modules ABFP diplomates take over the seven-year cycle.

"Now you won't be spending $3,000 or $4,000 to be out of the office for two or three days, fly to the test site, and have to stay in a hotel overnight," said Henley.

One rural FP described her frustration with rising malpractice rates, although her story certainly wasn't unique. In her home state, she said, there will be no chance for liability reform in the near future -- the trial lawyers are simply too powerful.
Unfortunately, said (then) AAFP President Michael Fleming, M.D., of Shreveport, La., "With the way the politics are right now, it's unlikely in the foreseeable future that the Senate's going to change enough to make a difference. The most likely place we can make a difference is at that state level."

But that's not the sole route Academy leaders are taking, added (then) AAFP President-elect Mary Frank, M.D., of Mill Valley, Calif. "When we say we need to work at the state level, that doesn't mean we're not working in Washington," Frank noted. "But the Democrats say reform the system through insurance; the Republicans say reform the system through tort reform. When we go to Washington, we're dealing with every coalition we can; we can't give up on either side."
Carol Ann Churchill, M.D., of Maryland Heights, Mo., a new member of the Missouri AFP Board of Directors, voiced her concerns about patients' concept of choice: "Choice is expensive, and as patients practice it, choice puts decisions about care in the home, with their neighbors, with the nurse who lives next door and says, ‘Oh, you're having chest pain, you ought to talk to the cardiologist down the street.'"
The problem, Churchill explained, is this: "They're not coming back to the family physician's office. Their PPO or HMO doesn't require them to have a family physician or primary care physician. There is nothing that ties the patient back to a primary care professional, and I think that's detrimental to care."

Part of the answer, said Frank, is to educate FPs and patients about what truly constitutes patient-centered care. "This is one of the big challenges coming out of the Future of Family Medicine report because people don't necessarily know what we do," she said. Once they understand that, they'll begin to value that care.

Stay tuned, said Frank. The Future of Family Medicine Task Force 6 report, to appear in the November/December issue of Annals of Family Medicine, will help connect the dots between giving that kind of care and getting paid for it.

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