Kellerman Calls for a Rebirth of Family Medicine

"The great mystery of health care in America today is not how to unlock the human genome or what the next imaging procedure will be,” said incoming AAFP President Rick Kellerman, M.D., of Wichita, Kan., in his president’s address on Sept. 28 at the AAFP Scientific Assembly in Washington, D.C. Rather, he said, “the great mystery of health care in America is why each and every American does not have a personal medical home with a family physician.

“The second great mystery … is why there are so many roadblocks and barriers and policies and procedures that prevent us from doing the job we want to do, and prevent patients from getting the health care they deserve.”

Kellerman told his audience that an abundance of research in the international, national, state and county realms has proven the value of family medicine. The research shows that health care systems that are based on the family medicine model result in “better mortality rates, better morbidity rates, better preventive care, better care of chronic illness, better quality of care indicators, and better patient satisfaction” at a lower cost than a subspecialty dominated system, he said.

Kellerman is in practice with the Medical Practice Association, Wichita, and also is chair of the family and community medicine department at the University of Kansas School of Medicine, Wichita.

He spoke of the joys -- and the heartaches -- family physicians encounter in their work. Delivering babies; receiving letters of gratitude from patients; and discovering, after a spinal tap procedure, that a child doesn’t have meningitis are real joys, he said.

Heartaches also come with the territory, said Kellerman, because “in family medicine we see people up close and personal.” Diagnosing patients with conditions that need medications, writing those prescriptions and then learning the patient cannot afford the medicine is heartache, he said.

Pointing out that 47 million people in the United States don’t have health insurance, Kellerman called for change. “At a time when the American health care system needs to cover 47 million more people, improve quality and safety, take care of an aging population, end health disparities, improve patient satisfaction, and restore the confidence of the public -- now is the time for a rebirth of family medicine and a renaissance of putting the patient first,” he said.

As Kellerman reminisced about the opening of his family medicine practice 24 years ago, he asked his colleagues to help him reaffirm the covenant he made with his first patients when he pledged to listen to the patient’s story, examine carefully and gently, work conscientiously and humanely, be honest and provide hope, care for the whole person, be nonjudgmental and provide guidance, comfort when there is no cure, and put the patient’s needs first.

We must “do our very best to ensure each and every American has access to a family physician who embodies these attributes,” said Kellerman. “This is why we are here, and this is what the future of family medicine is all about.”