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Monday Oct 20, 2014

My Year as President: The Honor Has Been Mine

It is hard to believe that a year has passed so quickly. In fact, I was blessed to have a 13-month term as AAFP president, and I did my best to make the most of it. In so many ways, this time on the AAFP Board of Directors has reminded me of my professional path, having worked as a small-town family physician before becoming residency faculty.  

I always tell new faculty at East Tennessee State University that you have to work at least five years to see the patterns in medical training and avoid the panic that often comes when challenges arise. Similarly, I am finishing my fifth year on the Board, and I have learned a lot in that time. It has been an exciting period, and I want to summarize some of my experiences.

 © 2014 Marketing Images/AAFP
Speaking with students, like I am here at the National Conference of Family Medicine Residents and Medical Students, is one important aspect of being the Academy's president.

When I was running for president-elect, I promised I was going to do my best to say yes -- and I have. This has been an amazing year. I topped 1 million miles on Delta and visited 17 AAFP chapters. One of the most profound experiences was the chance to meet not only the state leaders that we install in those chapters, but to meet our members who have chosen to put their energy into patient care and help our communities. Thank you for your dedication, your inspiration and for working through the many challenges. The time I have spent with you has helped me do a better job of understanding those challenges and representing family medicine in Washington, D.C.

I have spent a significant amount of time trying to reframe discussions about health care, including about scope of practice. Although this remains a significant issue from state to state, it's important to remember that we have a number of states that have allowed nurse practitioners to practice independently for years, and the results demonstrate this isn't the right solution to our nation's primary care shortage. Every state in our country is experiencing poor patient outcomes, decreased provider and patient satisfaction, and high costs.

The solution to these problems is to truly focus on increasing the number of primary care physicians in practice, creating more effective patient-centered medical homes, and providing care in a team-based fashion. The Comprehensive Primary Care Initiative(www.innovation.cms.gov) for example, is demonstrating that the kinds of changes the AAFP has been advocating for more than 10 years are the changes that lead directly to improved outcomes and decreased costs.

And there are more data to come, so stay tuned.

One facet of the president's job is to represent the Academy at meetings with other health care organizations, which creates opportunities to network and make important connections. After all, it's critical that team-based care also include organizational teams. I was honored to be invited to meet with a number of organizations -- some for the first time -- and help create new relationships for the AAFP or strengthen existing ones. Among the opportunities I have taken advantage of have been invitations to the Academy of Breastfeeding Medicine, the AMA, the American Academy of Physician Assistants, the American Association of Nurse Practitioners, the American Board of Family Medicine, the American College of Osteopathic Family Physicians, the American Osteopathic Association (AOA), the American Pharmacists Association, the Association of Family Practice Physician Assistants, the National Hispanic Medical Association, the National Medical Association,  the Society of General Internal Medicine, the College of Family Physicians of Canada and the Society of Teachers of Family Medicine.  

Another important role of the president is to represent the Academy in Washington, and I was fortunate to be able to make numerous visits to the nation's capital. The sustainable growth rate remains one of our biggest challenges, but I truly have hope that we are moving in the right direction. Proposed bipartisan and bicameral legislation already in play could provide a unique opportunity during Congress' lame duck session. Our comprehensive advocacy approach with organizations such as the AMA, the American College of Surgeons, the American College of Physicians and the AOA have created a unified voice for medicine that is getting the attention of those on the Hill.

We have other serious issues ahead, such as avoiding Medicaid cuts and addressing the regulated sunsetting of the primary care bonus, but we are opening more doors and sitting down at more tables to discuss these matters.  

Years of effort recently culminated in some major steps forward in graduate medical (GME) reform. The Institute of Medicine released its long-awaited report, with which the Academy substantially agreed. We followed that up with our own recommendations and a GME summit on Capitol Hill that was quite positively received. We are challenging long-held processes in significant ways. Much discussion and negotiation awaits, but once again, we are at another table addressing one of our primary goals.  

Just before coming to this week's Congress of Delegates and AAFP Assembly, I attended a premedical health fair at the University of California in Davis, a gathering of thousands of students who are considering careers in the health professions. In addition, I have been blessed to speak with students everywhere I have gone this year. Students are our life blood and our pipeline. These connections are critical, and I look forward to maintaining them.

One key way to stay connected is social media. Three years ago, the Academy made a commitment to giving members real-time updates about how the president is representing family physicians. The AAFP President's Facebook page(www.facebook.com) now has more than 1,400 "likes," and the AAFP President's Twitter account -- @aafpprez(twitter.com) -- has 2,400 followers. The Board also is providing regular and more in-depth updates through this blog. The better we stay informed and connected, the better we can advocate for each other.

It has been an honor to represent you, and I will continue to work for you during my year as Board chair. Thank you for the opportunity to take your stories forward. I am excited this week to be handing off the president's role to Bob Wergin, M.D. A small-town doctor who practices full-scope family medicine, he is the right person at the right place at the right time to lead us forward.

Reid Blackwelder, M.D., is president of the AAFP.

Posted at 08:56AM Oct 20, 2014 by Reid Blackwelder, M.D.

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