Town Hall Meeting Sparks Lively Discourse

The 2005 AAFP Congress of Delegates didn't open until Monday, but Academy delegates and alternate delegates, constituent chapter leaders, and members were already in the spirit of discussion during a town hall meeting Sept. 25.

AAFP Speaker Thomas Weida, M.D., of Lititz, Pa., introduced "a virtual smorgasbord of town hall topics": the Academy's new governance structure, AAFP "strike forces" on reimbursement and medical liability, and FamMedPAC, the Academy's federal political action committee.

The Academy has in recent years honed its focus on strategic planning, said (then) Board Chair Michael Fleming, M.D., of Shreveport, La. During the Board's 2004 strategic assessment, however, "We noted we weren't ready to do the job that our strategic plan called for within our commissions and committees."

The Board established a Subcommittee on Governance that year, approving the subcommittee's recommendations in May 2005, with changes to take effect in 2006. Chief among those changes is the establishment of nine commissions and eight subcommittees.

"This is a new governance structure. These are not our old commissions and committees with new names or new charges," Fleming said.

Some participants at the town hall meeting asked how issues pertaining to rural health would be handled under the new system, which dissolves the current Committee on Rural Health.

"There are two separate sets of issues here: issues of physicians who live and practice in rural areas and issues of patients who live in these areas," Fleming responded.

A new Commission on Health of the Public Subcommittee on Health Disparities & Underserved Populations will consider patients' issues, he said; the Commission on Membership & Member Services will handle physician issues.

Oklahoma delegate Steven Crawford, M.D., of Oklahoma City asked why the new schema no longer included a commission devoted to residents and students. Fleming said individual subcommittees within the new membership commission would represent each group, thus better integrating residents and students "into the mainstream of the work of the Academy."

(Then) AAFP President Mary Frank, M.D., of Mill Valley, Calif., chaired the reimbursement strike force. She said strike force members focused on private-sector advocacy, particularly regarding the value of integrating family medicine into employee health benefit plans, by making a business case that equates quality with cost savings.

"We need to be able to show large employers how they're going to save money, how they're going to get better productivity from their employees -- less absenteeism -- and better quality of care."

Also needed are tools to help Academy members enhance their bottom lines and supportive communications strategies, Frank said. Already up and running is a private-sector e-mail discussion list that lets members share questions, concerns and best practices on interacting with health plans.

(Then) President-Elect Larry Fields, M.D., of Ashland, Ky., shared a take-away from the medical liability strike force he chaired: "We concluded that at the end of the day, whatever reduced the rise in medical liability premiums was considered a success."

Texas delegate Dale Moquist, M.D., of Houston noted that reforms instituted in his state lowered premiums by 17 percent in 2004 and 2005, with another 5 percent drop expected in 2006.

Fleming, who chairs the FamMedPAC Board of Directors, responded to concerns that donations to the PAC would "siphon off" contributions to AAFP Foundation programs. The foundation's recent success in raising funds to support Gulf Coast residents, including FPs, devastated by hurricanes Katrina and Rita belies that view, he said.

Frank gave participants an impressive review of recent meetings she's had with federal lawmakers in which she was able to advance family medicine's legislative agenda -- meetings she said never would have happened without FamMedPAC contributions.

"You give to the foundation with your heart," said Fleming. "I want you to give to the PAC because of your brain."