As President-elect Donald Trump begins working on the important issues of his administration, the AAFP wants to ensure that recognizing family medicine's value to the health care system is high on the agenda.
AAFP President John Meigs, M.D., of Centreville, Ala., sent a letter to Trump today(2 page PDF) with specific recommendations about what his incoming administration can do to help family physicians better care for their patients.
"Primary care -- and particularly family medicine -- is foundational to continued progress in reforming the health care system," Meigs wrote. "The complexity of care provided by family physicians is unparalleled in medicine."
Meigs grouped the AAFP's priorities into five categories: expanding access to care, ensuring delivery and payment reform, improving affordability, building the primary care workforce, and promoting wellness and prevention.
- AAFP President John Meigs, M.D., of Centreville, Ala., sent a letter to President-elect Donald Trump outlining how the incoming administration can support the important work of primary care physicians.
- Meigs recommended that Trump take steps to make health care more accessible and affordable for all Americans.
- Payment policies should reflect the value of the initial and comprehensive care that family physicians are providing their patients, he wrote.
"Family physicians need your administration to make these a priority as we reform and improve America's health care system," Meigs wrote.
Rising costs for insurance premiums and pharmaceuticals are forcing some patients to make difficult choices about their health -- choices they would not have to make if they could afford necessary care. Meigs recommended that Trump take steps to make health care more affordable for all Americans.
"Ensure that patients do not face financial obstacles to securing primary and preventive care, especially those individuals who have high-deductible health plans," Meigs urged.
Expanding Medicaid in all 50 states and reauthorizing the Children’s Health Insurance Program (CHIP) are two important steps toward ensuring access for Americans with low incomes.
National health care policy also should reflect the value of the initial and comprehensive care that family physicians continue to provide their patients as they adjust to new payment models under the Medicare Access and CHIP Reauthorization Act (MACRA).
The new administration should ensure that MACRA "is implemented in a manner that facilitates success among all family physicians, regardless of practice size or location," Meigs wrote. "A special degree of attention and support must be paid to independent solo and small group practices in all geographic areas."
Meigs asked the incoming president to develop a national strategy that promotes primary care as fundamental to public health. He cited research indicating that patients with multiple conditions seek out family physicians rather than subspecialists. Family physicians also address more diagnoses during a single visit than subspecialists do, he wrote.
"Those findings heighten the importance of implementing policies that value primary medical care and build the primary care physician workforce," said Meigs.
Because a large segment of the physician workforce receives training in hospital-based residencies, the physician pipeline often reflects the needs of hospitals rather than those of the larger community that funds graduate medical education (GME). To remedy this, GME should be reformed to focus on training physicians in communities that need primary care. Meigs highlighted the successful Teaching Health Center GME program as one pathway that should be expanded into more communities.
The letter reflects the understanding of physicians and communities that office-based treatment alone is not enough to improve health outcomes for individuals and populations. The availability of grocery stores and public parks, for instance, can influence an individual's physical health. Meigs advised Trump to support the incorporation of social determinants of health into all health care delivery systems.
He also called on Trump to help increase vaccination rates for children and adults by "improving access to vaccines for family medicine practices, reforming the vaccine supply chain and creating payment policies that appropriately promote the delivery of vaccines, as appropriate, to all patients."
Meigs closed the letter by pointing out that ensuring "an accessible, high-quality, efficient and diverse health care system" is an important part of improving people's lives.
"I and our members stand ready to do the important and hard work necessary to achieve these goals," he concluded.
Related AAFP News Coverage
MACRA: The Medicare Access and CHIP Reauthorization Act