AAFP is 'Pawn' in Health Care Reform; Academy Responds 'Not So'

To the Editor:

As someone who has been involved with advocacy for many years, I'm writing to express my brutal disappointment in the AAFP's positioning and effectiveness in the recent health care debate. ("Academy Leaders Carry Family Physicians' Message to White House, Capitol Hill," March 5, 2010)

Although family physicians are in critical need of advocacy for their issues -- payment reform, a repeal and permanent fix for the sustainable growth rate, liability reform, recognition of the value of family medicine, graduate medical education reform, etc. -- the AAFP seems to have become more enamored of photo opportunities at the White House than the needs of members.

In my opinion, the AAFP has been used by most of Washington as a pawn in a $2 trillion chess game -- and the pawn can never win. The AAFP could have taken the high road of quality care for patients and fair payment for the most valuable health care providers. Instead, the organization has gone "all in" for one highly partisan bill that will have absolutely no effect on the issues I listed above.

The organization and its leaders need to take a close look at themselves and be reminded of the reason the AAFP actually exists: to meet the needs of its dues-paying members.

Michael Fleming, M.D.
AAFP Past President

Academy Response:
I appreciate Dr. Fleming's point of view. But when it comes to health care reform, we have to remain true to the path the AAFP Congress of Delegates approved. We must hold on to the AAFP’s long-standing principles of health care for all, a system founded on appropriately paid primary medical care, and a replenished pipeline of family physicians.

Although not the end game, the health care legislation currently in Congress takes important steps in that direction. It expands coverage to more than 30 million Americans. With its 10 percent Medicare bonus for primary care physicians and pilot testing of the patient-centered primary care medical home, it embarks on reshaping our health delivery system based on primary medical care. And it invests in primary care training by expanding scholarships and student loan forgiveness programs for medical students entering primary care.

Certainly, the legislation misses the mark in some areas. But the AAFP's work in shaping health care reform has put family medicine in good stead for future legislation that will address, for example, the flawed sustainable growth rate formula and potential reform to the medical liability system. Far from being a pawn, the AAFP has been able to shape the legislation, which shows the first recognition of the value of primary care.

Nothing is perfect. But we must make a start. The best start we've had in 16 years is the legislation now before Congress.

Lori Heim, M.D.
AAFP President