Wanda Filer, M.D., M.B.A., of York, Pa., has no problem showcasing family medicine as the specialty of choice for medical students. And she's not shy about saying every patient needs a family physician. Every word, every story, comes from the heart because she lives and breathes her specialty.
Wanda Filer, M.D., M.B.A., enjoys the diversity of patients she sees -- including lively 7-year-old boys like Ben Swartz -- at Lewisberry Center, 25 miles north of York, Pa. It is one of five community health centers operated by Pennsylvania-based Family First Health.
AAFP News recently visited with Filer as she was between seeing patients at a Family First Health community health center in Lewisberry, Pa., to talk about her upcoming presidential year and where she will focus her energy.
Q. During your presidential year, you'll be spending a lot of time in Washington working on behalf of family physicians. What issue will be at the top of the AAFP's list as you speak with legislators and policymakers?
A. The Academy is set to elevate the reputation and the value of family physicians. For instance, improving payment is a priority, because when physicians are paid fairly for the services they provide, they know their work is valued. I want family physicians to understand that they are engaged in a noble profession and that they are making a difference in the lives of individuals and communities.
Q. Your term as AAFP president will involve much travel and consume a good deal of your time. Why is this leadership role important to you?
A. I know that I can tell the family medicine story. Our specialty is the best tool we have to change the trajectory of American health care. This country needs to spend more money on primary care and less on fragmented specialty care. Let's put our money where it can impact the health of the people.
- Wanda Filer, M.D., M.B.A., just installed as the AAFP's new president, recently sat down for a Q&A with AAFP News.
- Filer said her work taking care of patients in community health centers will help her connect with legislators and policymakers when she communicates about the importance of family medicine.
- Value-based payment, advance care planning and chronic care management all are issues to which the AAFP will devote much attention in the coming year.
Q. Family physicians still face a lot of hurdles when it comes to health information technology, especially in terms of usability, workflow and interoperability. What's your personal comfort level with electronic health records (EHRs)?
A. I'm now on the fourth EHR of my career. One was such a dismal product that we simply walked away from it. Physicians have heard a lot of good sales pitches, and we've seen a lot of people who weren't involved in clinical care leading us to the health IT "promised land." This has been a difficult journey for many of us, but the Academy is working with stakeholders to turn this situation around and help ensure that EHRs help, rather than hinder, physicians in practice.
Q. How will your work in community health centers help frame your message about patient access to care?
A. I have very concrete examples of patients whose care was delayed -- and whose conditions worsened -- because they had no health insurance. I've also seen patients who were unable to achieve optimal health because of food insecurity, poor living conditions and illiteracy. I can put names and faces to these people and personalize the stories I deliver to our elected officials.
Q. ICD-10 is here. Are you ready?
A. My first full day on the job as AAFP president, Oct. 1, is ICD-10 implementation day. And, no, I am not as prepared as I should be. But like many of my family physician colleagues, I'm relying on my Academy to provide the resources I need to help make this transition.
Q. What can the Academy do to help family physicians understand and prepare for value-based payment?
A. We need to stay on top of this issue; the devil is in the details. If value-based payment is simply another round of undervaluing primary care, then it's a nonstarter. But if policymakers intend to pay family physicians for the care they provide to patients -- for services like care coordination -- then value-based payment could provide a huge opportunity for family medicine.
Q. How would you characterize the AAFP's hard-fought wins on payment for advance care planning and chronic care management?
Medication reconciliation is an important part of primary care and one that Wanda Filer, M.D., M.B.A., takes seriously during a patient visit with Kathryn Chamberlain.
A. Advance care planning is a big win for physicians and their patients. It's something the Academy fought for, and frankly, a service family physicians have been providing to patients for years despite the lack of payment. The next step for the Academy is to help family physicians understand why it's good for their practices.
I've heard unbelievable success stories from practices that have deployed chronic care management codes and have improved not only their bottom line but quality metrics, too. It will be important for physicians to reassure patients that they'll receive even better care with fewer office visits, and that's messaging the Academy can help with. The necessary practice changes will take time, but physicians who put in the effort will be glad they did.
Q. We often hear members say they are drowning in government regulations surrounding programs like meaningful use and the Physician Quality Reporting System. Do you feel their pain, and what can be done to alleviate administrative burdens?
A. I do feel their pain. I'm tired of checking boxes that do not seem to have any apparent benefit to patients. More face time with patients is a better use of my skills and my training. The Academy is carrying our "cut the red tape" message to D.C. on a very regular basis.
Q. How can you assure your family medicine colleagues who own small practices that the Academy is looking out for their interests, too?
A. The Academy recognizes that some of the best patient care and outcomes come from small family medicine practices, and we will continue to develop tools to help them in their work.
Q. A growing number of family physicians are fired up about a new model called direct primary care. What are your thoughts about this new way of running a medical practice?
A. Direct primary care is a model family physicians should study and consider, and one that medical students and residents already are very excited about. Direct primary care could be transformational, particularly for smaller practices in certain geographic areas.
Q. What do you love about family medicine?
A. I love the people -- both my patients and my colleagues. Physicians in other specialties don't have the opportunity to get to know their patients the way family physicians do, and it's such an honor to forge those patient relationships. Watching my family medicine colleagues fight for their patients when no one else will reinforces for me just how incredibly noble this profession is.
Q. What is your biggest strength, and how will that translate to your role as the AAFP president?
A. I am pretty solid on incorporating a large amount of information from different sources and finding a way to use that to family medicine's advantage. For example, I went back to school and earned my M.B.A. because it became clear to me that I needed to speak the language of business in order to share family medicine's value proposition for America to payers, policymakers and employers.
Q. How do you relax and have fun?
A. My husband, Bob, who is also a physician, our two daughters and I have traveled quite a bit together. In fact, our girls grew up experiencing the action at our Pennsylvania AFP chapter meetings. I actually thrive on chapter visits and interacting with people. I love to travel, so this position and its requirements are a good fit for me. When I am home, I enjoy our two golden retrievers.