ALF/NCSC Town Hall Meeting

Future of Family Medicine Project to Define Specialty, Underscore Its Value

May 07, 2014 02:42 pm David Mitchell Kansas City, Mo. –

AAFP Board Chair Jeff Cain, M.D., of Denver, was stunned -- and somewhat amused -- when he heard a neurosurgeon refer to himself as a primary care physician during a recent medical conference.

AAFP Board Chair Jeff Cain, M.D., center, speaks during a Town Hall meeting held as part of the Academy's Annual Leadership Forum and National Conference of Special Constituencies. President-elect Robert Wergin, M.D., left, and President Reid Blackwelder, M.D., also spoke during the May 2 event.

With interest in primary care growing among payers and policymakers, and incentives being paid for some primary care services, that neurosurgeon wasn't alone.

"There was a line of 'primary care-ologists,'" Cain said May 2 during a town hall meeting held as part of the AAFP's Annual Leadership Forum and National Conference of Special Constituencies. "We're popular right now."

With so much interest, now is a good time to define what primary care physicians -- and, more specifically, family physicians -- really are. AAFP officers said that important issue and many others will be addressed in Family Medicine for America's Health: Future of Family Medicine 2.0 (FFM 2.0) when the report is released this fall in the Annals of Family Medicine.

The AAFP and other family medicine organizations have been working on the FFM 2.0 project since August 2013. The project will define the role of the 21st century family physician and ensure family medicine can deliver the workforce needed to fulfill this role for the U.S. public.

When completed, the project will produce a communications strategy targeted to consumers, payers, policymakers and the medical community that aims to -- among other things -- increase patient understanding of the value of primary care and improve patient engagement in prevention and health care management. It also is intended to help shift the current payment structure to a system that supports the success of family medicine and primary care in meeting the triple aim of improving outcomes, lowering costs and enhancing the patient experience.

"We're going to define what a family physician is and make it evident to the public -- and, more importantly, to leaders in Washington -- so they can understand the importance of family medicine and value it appropriately," said AAFP President-elect Robert Wergin, M.D., of Milford, Neb.

Academy EVP and CEO Douglas Henley, M.D., emphasized that the communications effort will "fundamentally explain the difference between primary care physicians and others who might provide certain primary care services."

GME Funding

Ensuring an adequate workforce includes addressing inadequacies in the current graduate medical education (GME) system, Cain told attendees.

The best health care systems in the world have 40 percent or more of their physician workforce devoted to primary care, he noted. In the United States, the figure is roughly 32 percent. "We need to move the country to a health care system that has primary care and family medicine as its foundation," said Cain.

He pointed out that the Council on Graduate Medical Education (COGME) has issued a report that calls for increased GME funding and asserts that increases should be prioritized for certain specialties, including family medicine.

Cain said that supportive papers from groups like COGME and the Medicare Payment Advisory Commission aren't enough, and the Academy is working to move the conversation forward with legislators, congressional staff and other stakeholders.

The United States is spending $13 billion a year on GME, said Cain, yet the nation is facing a critical shortage of primary care physicians.

"The outcome is not what's best for our country," he said. "It's what's best for hospitals' bottom lines. That's not why we pay taxes. We're paying for the health care system we need."

Member Interest Groups

AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn., discussed the Board's approval of recent recommendations from a task force that was convened last year to evaluate how the Academy could better serve the specific needs of various member groups. Those recommendations include creating a pathway for members to form interest groups that will allow them to share their mutual interests, address common concerns and connect with the AAFP.

After meeting certain criteria, member interest groups would have the option to petition the Board to transition to a member constituency.

"One of the strengths of an organization is the ability to review its processes and purposes," said Blackwelder, who chaired the task force. "We looked inward and asked, 'Who are we, and are we best representing our members?' We heard clearly from members that there were groups of members -- especially in this rapidly changing health care environment -- we weren't properly addressing, or creating a forum for their needs."

Blackwelder also announced that ALF and NCSC will be renamed the AAFP Leadership Conference for Current and Aspiring Leaders when the event returns for its 25th year in 2015. The event will have two tracks, the Annual Chapter Leader Forum and the National Conference of Constituency Leaders.

Membership Numbers

AAFP membership has swelled to an all-time high of 115,900 members, Henley announced. The total number of members increased by more than 5,000 compared to the same time last year and has seen a 28 percent increase since 2007.

Moreover, increases were seen across membership segments, including active, resident and student members. Of particular note: The Academy now represents 28 percent of all U.S. medical students, with 26,900 student members.


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