Raise a glass this month to a date that marks the anniversary of an event important to you, your practice and your patients.
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From the President
Ponder This as AAFP Turns 60: What if There Had Been No Academy?
Sixty years ago on June 10, a group of about 200 general practitioners, or GPs, gathered in Atlantic City, N.J., to establish what eventually would become the American Academy of Family Physicians. The organization originally was called the American Academy of General Practice, and its founders were responding to a crisis eerily reminiscent of America's health care system today.
At the time, medicine was increasingly dominated by limited specialists. The number of GPs was shrinking. The Academy's founders were fighting on behalf of America's families, who needed the GPs' type of comprehensive care. The founders were fighting for respect for their critical role in medicine, for hospital privileges and for the financial lives of their practices.
Since then, the Academy has been a champion on the front lines on behalf of its members and their patients. So as you reflect on the 60th anniversary of the Academy's founding, here's an appropriate question to ponder: What would America's health care system be like today, if the Academy hadn't been established? Consider the possibilities!
- Without the Academy, general practice might have withered away entirely, instead of blossoming into family medicine. Or GPs might have remained an unorganized, ill-defined bottom layer of the medical care delivery system. Either way, without the Academy's influence over time, today's health care system might have become even more subspecialty-focused and dysfunctional than it currently is.
- The Academy bridged the gap between the GPs and the new family medicine specialty. Without the Academy's advocacy, the (then) American Board of Family Practice wouldn't have established a practice-eligible route to board certification for GPs to become FPs. Furthermore, very few GPs would have chosen to become board-certified without the Academy's encouragement -- and they would have had difficulty attaining certification without the help of the Academy's CME offerings. The newly established board had no direct contact with GPs; the Academy was the conduit to the real, live docs. In many other countries, the gap between GPs and FPs has never been closed, resulting in battles between the two groups to this day.
- The Academy was the first major medical organization to require CME as a condition of membership. Think what medicine might be like without ongoing clinical education.
- The Academy reached out to GPs in practice and helped them become residency directors and department faculty, and it lent staffing support to the fledgling Society of Teachers of Family Medicine. The specialty needed to have residency programs to gain parity with other specialties. So without the Academy, there might not have been parity -- or a family medicine residency available to teach you how to become a family physician.
- State and federal government funding to support family medicine training might never have been established if the Academy and its constituent chapters hadn't lobbied for it. On the federal level, once these funds were established, they probably would have disappeared the first time a U.S. president decided to cut them from his budget proposal. Instead, the Academy has gone the long mile to restore the funds.
- Absent the Academy's ongoing advocacy in concert with the AMA and other organizations, all (instead of some) of the annual payment cuts triggered by Medicare's sustainable growth rate formula likely would have gone into effect -- making it completely (instead of almost) impossible for your practice to survive. Without the Academy, the debate in Congress about reforming the Medicare payment system would not be as robust as it currently is.
- There never would have been a Future of Family Medicine project without the Academy. That project, launched in 2002, envisioned family medicine's evolution to the next level. There also never would have been TransforMED, the AAFP initiative designed to help family physicians undertake the needed practice transformation.
- Looking outside our borders, family medicine would have had less of a global presence than it has now if the AAGP hadn't helped found the World Organization of Family Doctors, known as Wonca. American backing gave impetus to the worldwide movement toward upgrading general practice.
- Finally, without the Academy, major employers such as IBM would have lacked the perfect partner in their efforts to convince others, including government, of the benefits of a primary care-based health care system. These employers know the difference primary care has made in other countries, in terms of health outcomes.
Here's the bottom line: While it's far from perfect, the care of American patients today is better than it would have been, had the Academy never existed. And the Academy is playing a central role in reforming the health care system for the benefit of all. So toast the Academy's 60th anniversary -- and stay tuned. With your support, the Academy will continue to agitate for change, so that you can care for patients in an environment that works well for you and for them.
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