October 14, 2020, 9:00 am David Mitchell – The Family Medicine Experience offers CME on 160 topics. In her address as the newly installed AAFP president on Oct. 13, Ada Stewart, M.D., offered a lesson on a topic that FMX attendees might not have expected – U.S. history.
“It is said that the health care industry is recession-proof, but the primary care sector is decidedly not pandemic-proof,” said Stewart, a family physician from Columbia, S.C. “Even before the pandemic, primary care was in crisis.”
Stewart said 20% of primary care practices closed temporarily during the pandemic, while 40% were forced to furlough staff and physicians. Those figures are in stark contrast to the need for care at a time when millions of Americans have been infected by COVID-19 and hundreds of thousands have died.
“Let us not waste this crisis,” Stewart said. “For history has shown that it is only during times such as these that true reform can be achieved. More and more Americans have awakened to the tragic realities of our health care system: a system that costs too much; a system that neglects the poor, the disadvantaged and people of color; a system that is failing us during our hour of greatest need – the worst health care crisis in more than a century.”
Stewart’s example from history was the Civil Rights Act of 1964, which was the product of “interesting times such as these” and passed, in part, because its advocates were unwilling to wait for the type of incremental changes that had been produced by civil rights legislation passed in 1957 and 1960.
During the March on Washington in August 1963, John Lewis (who later served more than 30 years in Congress before his death earlier this year) expressed “a great sense of misgiving” about legislation then being debated in Congress and said Black people could no longer be patient.
The 1964 law ultimately outlawed discrimination based on race, color, religion, sex and national origin. It also prohibited racial segregation in schools and public accommodations and unequal application of voter registration requirements.
“The leaders of the civil rights movement perceived that a great revolution was sweeping the nation – a revolution to make complete the unfulfilled promise of the one that began in 1776,” said Stewart, the first Black woman to serve as AAFP president. “All that was required was an awakening – a lightning strike – and a movement ready to seize the moment.”
With a growing AAFP membership of 136,700 family physicians and an 11th straight year of growth in the National Resident Matching Program, Stewart said it’s time for the specialty of family medicine to have a movement of its own.
In the wake of the pandemic, she compared to the U.S. health system to a rotting old tree that was even weaker than people realized. Struck by lightning, the tree was revealed to be hollow at its core.
“This tree – the status quo of our health care system – cannot be saved,” she said. “It must be replaced. Now is not the time for patience and waiting. Now is not the time for despair.”
Borrowing a phrase from Martin Luther King Jr., Stewart said family physicians should be filled with “the fierce urgency of now” to achieve health care equity, build a resilient and diverse physician workforce, and promote a science-based and coherent national response to the pandemic.
“We can insist that family medicine take its rightful place as the foundation of a high-quality health care system, a system that serves the needs of everyone,” she said. “We can achieve these things, just as John Lewis proclaimed, ‘by force of our demands, our determination and our numbers.’”
Stewart said she is “but one voice” and urged other family physicians to join her with a collective resolve to achieve the Academy’s mission to “improve the health of patients, families and communities by serving the needs of members with professionalism and creativity.”
Finally, Stewart quoted President Barack Obama, who said, “One voice can change a room.” Put succinctly, Obama said that if one voice can change a room, then it can change a city, a state, a nation and the world.
“If one voice can change the world,” Stewart said, “then the collective voices of family physicians across this country can change the health care of our nation.”