My Illuminating Experience Working on Your Behalf

It's amazing what a difference five years can make.

Five years ago, I'd been an Academy member for 21 years but hadn't really been involved in either the national Academy or my constituent chapter, the Minnesota AFP. But that began to change the day I received a solicitation from the MAFP, encouraging members to consider serving on an AAFP commission.

"Why not," I found myself thinking. I had some financial background and experience working with insurance companies, so I expressed interest in the AAFP Commission on Finance and Insurance. Not long after, I was appointed to the commission.

Many members have worked their way up to national involvement though their state chapters, which takes time. I turned that process on its head in a sense, jumping straight to the national level. That worked very well for me -- and the experience I've had in the past five years has been illuminating.

You might think that serving on the Commission on Finance and Insurance would be bone dry and boring, but it actually has been extremely interesting -- and sometimes fun to boot.

Here are seven things you should know about the commission's work on your behalf:

Before the AAFP's proposed annual budget goes to the Board of Directors, it has to pass muster with our commission -- twice. As commission chair, last winter I met with our Board liaison and senior staff to review the nitty-gritty of the proposed budget for the fiscal year beginning in June. Budgets may look dry, but believe me, there can be passion behind them -- a line item may be someone's potential program, conceived with the intent of meeting a member need and backed by good, thoughtful opinions by the people who have proposed it.

As I reviewed, I measured each budget item against this yardstick: "Is this a good way to spend the membership dues of hard-working family doctors?" If the budget for a proposed project were $80,000 -- equivalent to the dues of about 200 members -- I asked myself, "Would I feel comfortable telling 200 members that we spent their dues on this?"

We respectfully probed to learn the assumptions behind the numbers, sometimes asking people to go back and sharpen their pencils if their parts of the budget seemed to still need work.

A few weeks later, at the annual meeting of our full commission, the budget proposal ran through yet another gauntlet of scrutiny.

This process happens each and every year, resulting in a budget that is fully and carefully vetted before it ever reaches the Board for approval.

Proposed dues increases go before two commissions, not just one, on their way to the Board. First, the Commission on Membership and Member Services considers the increase from the member perspective: How will the increase affect members? What is the member value? That commission makes a recommendation to our commission, and then we look at the proposal from the budget perspective: Will there be enough revenue coming in to keep the budget balanced?

Our recommendation to the Board includes background and insights from both commissions. This two-step process ensures that the Academy won't raise dues unless there's a justifiable reason for it.

Once the budget is approved, our commission monitors the Academy's financial performance each and every month. We carefully examine the monthly financial reports, and we arrange for the annual audit by a licensed CPA.

Our commission monitors the AAFP's investment portfolios. During the financial meltdown in 2008-2009, I remember watching the Dow ticker crawl across the television screen during our commission meeting and thinking about what the downturn meant for the Academy's finances.

We are very mindful of our responsibility to have the best fund managers and the proper amount of risk for return, so the Academy will have the money necessary to support programs and services for you.

We periodically review the offerings of AAFP Insurance Services. We want to make sure the insurance offerings serve your needs. For disability insurance, for example, we assess whether the coverage would really protect a member's income and family at a time when he or she couldn't work. When members suggest new insurance products, we assess those ideas, too.

The commission reviews resolutions to the Congress of Delegates that could potentially harm the AAFP's finances. AAFP staff members provide estimates of financial impact, and then the commission decides whether to speak about any of the resolutions in reference committee. However, often we haven't had to testify because delegates reached the same conclusions that we reached and said the same things about financial impact that we would have said. I think this demonstrates the wisdom of our membership and our commission's alignment with members.

The commission has the final say in setting honoraria and expense reimbursement for Academy officers and others representing AAFP on official business. This past year, we reconsidered the size of the honoraria given to AAFP officers. We did this because some members had expressed concern about the financial impact on FPs in private practice when they win election and become president-elect, then president, and then Board chair. The concerned members wanted a level playing field so that all members, including private practitioners, could become AAFP president and be the voice for America's family doctors without damaging themselves financially.

The commission struggled with the issue during a telephone meeting this past summer. The next time we discussed it, we tapped the experience of the outgoing Board chair to get a feel for the current workload of the three positions. The new information helped, but we still searched for the right answer.

In the end, one of our newest members spoke up, crystallizing the issue and giving us a new way to look at it, leading to a proposal that we were glad to adopt.

Which brings me to my final point: Why don't you become one of those new commission members who provide a fresh perspective on the Academy's work? Step forth and volunteer to serve like I did.

In the past five years, I've learned so much about the Academy. I've appreciated the diligence and sincerity of my commission members and the good work of the other commissions. I've experienced the professionalism and passion of national staff and everyone's commitment to programs that bring value to members. I've realized the tremendous personal and time commitment that Academy officers make. It all has been very reassuring and inspirational to me as an AAFP member.

That's what I found during my commission experience. I'm sure you will, too.

Patrick Herson, M.D., of St. Paul, Minn., is the outgoing chair of the AAFP Commission on Finance and Insurance. His AAFP commission experience has inspired him to get more involved in his constituent chapter. He's now begun a term on the Minnesota AFP's Committee on Finance.