Differing Views, Member Priorities Challenge AAFP

Family medicine is changing, as is the membership of our association. And those changes are presenting some interesting challenges to the Academy, which now represents more than 105,000 members -- up nearly 10,000 compared to just two years ago -- from diverse practice backgrounds.

We recently published the results (1-page PDF; About PDFs) of our annual membership satisfaction survey. Although we are constantly striving to do better, I was encouraged to see that overall member satisfaction was 78 percent, up 4 percent from 2010 and 2011.

What's interesting is how varied the responses were when broken down by demographics. For example, 79 percent of respondents agreed with the statement that "the AAFP is doing a good job of representing the specialty of family medicine." The percentage of those agreeing was much higher among women (88 percent) than men (76 percent). Women (87 percent) also were more likely than men (74 percent) to agree with the statement that "the actions of the AAFP support its mission to improve the health of patients, families and communities by serving the needs of members."

There were similar gaps between employed physicians (69 percent) and practice owners (60 percent) on whether the Academy's leaders are leading the AAFP in the right direction. New physicians (87 percent) were significantly more likely than non-new physicians (77 percent) to agree that they benefit from being an AAFP member.

Employed physicians (82 percent), women (86 percent), and new physicians (88 percent) all reported satisfaction levels that were higher than the aforementioned 78 percent. Certainly, there is overlap in these three categories. According to our member census, more than 80 percent of our new physicians are employed, and more than 70 percent of our female members are employed. More than half of our new physicians are female.

Twenty-five years ago, employed physicians accounted for less than one-third of the Academy's membership. Today, the percentage has more than doubled, and employed physicians now account for 60 percent of membership. During the same time, the percentage of solo physicians has dropped from 44 percent to 17 percent.

In a survey of employed family physicians, only 13 percent of respondents indicated interest in owning a share of their practice.

It is vital that we understand the needs of this growing number of employed physicians and the trend toward employment. At the same time, we must continue to support the solo and small practice physicians, who remain critical to the health of their communities, especially in rural and underserved areas.

The challenge presented is that different types of members have divergent priorities. For example, when we asked members to select three issues that should be priorities of the AAFP this year, more than half selected payment reform and 40 percent selected medical liability reform. But four other issues -- helping FPs maintain board certification, working within the health care reform law to preserve gains for primary care, workforce issues and scope of practice -- garnered roughly the same amount of support, ranging from 23 percent to 25 percent.

Some differences in priorities were significant. Employed physicians (50 percent) were 12 percent less likely than practice owners (62 percent) to select payment reform as a priority, and they were 8 percent more likely to select workforce issues.

New physicians (28 percent) were significantly less likely than non-new physicians (42 percent) to select liability reform, and they were 8 percent more likely than their more experienced colleagues to pick scope of practice.

We also asked members how they would distribute $100 if they had to divide it among the Academy's four strategic objectives: advocacy, continuing medical education, health of the public and practice enhancement. Again, there were some interesting differences. Employed physicians put more emphasis on health of the public than practice owners, and they put less emphasis on advocacy and practice enhancement than practice owners. New physicians (who are more likely to be employed) also put more emphasis on public health issues and less on advocacy than non-new physicians.

There was agreement, however, on some important questions. More than 80 percent of respondents said their AAFP membership was important. Nearly 80 percent said they benefit from being a member, and more than three-fourths said they would recommend membership to other family physicians.

Those are encouraging statistics, and they remind the Academy that our mission is bringing value to all of us as members, regardless of how and where we practice and whether or not we own that practice.