• Inaugural Address of AAFP President Tochi Iroku-Malize, M.D., M.P.H.

    Delivered Sept. 21, 2022, at the Family Medicine Experience in Washington, D.C. 

    Good afternoon, everyone. My name is Tochi Iroku-Malize, and as mentioned in the video, I hail from New York.

    Let’s start by recognizing the original people of this land on which we are celebrating.

    I learned that the indigenes would be the Nacotchtank people. I am no expert, however what I can share is they were a people who lived in this area during the 17th century. They thrived until European explorers came and brought with them disease that devastated the tribe. By 1700, nearly all the tribe’s people were gone. We honor their memory as we proceed with our festivities.

    I am truly honored to serve as your president.

    My parents were immigrants — one a surgeon, the other a nurse midwife — and both of them shaped my life.

    I have three siblings — a lawyer, a health care administrator and a gastroenterologist — and I remind them regularly of the of importance of primary care.

    I have a long history with the Academy.

    My parallel journeys with the AAFP and as a family physician leader can be classified as being willing to say “OK” to new opportunities.

    It began in the summer of 1999. At my orientation at the Southside Hospital Family Medicine Residency Program on Long Island, my colleagues and I signed a document that stated we were now members of the AAFP.

    I didn’t know what it meant. But my program director, Dr. Richard Bonanno, knew the importance of being involved in our specialty society to influence how family medicine progressed.

    So I said OK.

    He then encouraged me to get involved as a resident leader in the New York State Academy of Family Physicians.

    I said OK.

    So, as a resident, then chief resident, I was involved in advocacy and academics. While finishing residency, I was asked by the medical director to help start up a new hospital medicine program. Remember from the video that I told them I would only be at the institution for three years. So this offer was of no interest to me. However, he told me that I could set up the program and then continue on my way after a year.

    I said OK.

    Meanwhile the residency associate program director, Dr. Scott Kirsch, was retiring. He and Dr. Bonanno asked if I would become the next APD.

    I said OK.

    Then my program director decided to retire several years later, and he asked me to take over his role.

    I said OK.

    Did I mention that I had also set up a solo practice and was seeing my private patients?

    Then our health system decided to open a medical school and asked me to assist with the curriculum development.

    I said OK.

    And when I was offered the job of chair, after advocating for an official family medicine department in the medical school…

    I said “hold on, let me think about it.”

    After consulting with Dr. Bonanno, Dr. Kirsch, my mom and husband, I decided to say OK.

    Twelve years later, I am now also the senior vice president of the family medicine service line.

    A shout-out to my Family Medicine family and the Northwell Health team for making my job so great.

    As my professional career advanced, I continued my work in the NYS academy and the AAFP. Serving as state president and on multiple committees helped me have a better understanding of our organization at both the state and national level. I continued ongoing advocacy in Albany and here in D.C. on behalf of our specialty, which seems like an overwhelming task, but my mother, Dr. Rachel Iroku, showed me by her life work that no task is insurmountable.

    I’ve known the Academy longer than I’ve known my children. My oldest was 6 months old when he attended his first NYSAFP board meeting. He turned 22 earlier this month. I have been fortunate that my husband, Charles, has partnered with me to bring the kids to the Academy events for over two decades.

    Being on the national Board has afforded me the opportunity to learn from all of you as I visit your states, live and virtually.

    And after all these years I am now considered a seasoned member of the academy.

    If I divide my life into before 50 — the first act — and afterwards — the second act — it’s easier to reflect. Between the intro video and my remarks so far you’ve heard quite a bit about my first act. So let’s see what has happened so far in my second act.

    When I was 50, I was elected to the AAFP Board of Directors. I thank you for that.

    At 51, I was diagnosed with cancer, had two different cycles of chemotherapy, total body radiation and a stem cell transplant. It worked — I’m here. Thank you, God.

    At 52, I was gowned up from head to toe caring for patients in the midst of COVID while doing media interviews trying to dispel misinformation.

    At 53, I ran for and was elected AAFP president-elect. Again, I thank you.

    At 54, I am your president.

    At 55 I will hand over the reins to Dr. Steven Furr and become Board chair.

    And at 56, I will complete my official duties for AAFP while celebrating my 25th anniversary as an AAFP member.

    But I will forever be an active member of this organization.

    Much of my work on the Board so far has focused on expanded scope of practice, maternal mortality and morbidity, rural access issues and the family medicine pipeline.

    When I ran for president-elect in 2021, I outlined my plan for the next three years based on three things: Be better, do better and live better.

    First, how can we be better?

    • Never settle,
    • Become change agents willing to innovate in caring for our patients,
    • Continue our professional and personal growth, and
    • Correct inequities in our profession and in health care.

    Second, how can we do better?

    • Advocate, take a stand, create opportunities, help those who need assistance, support and pull up those behind you, and honor those in front of you.
    • Politics, business and health are intertwined. We need to continue to leverage our collective political capital to get policies that materially improve life for you and our patients.
    • Increase opportunities for you to serve as leaders and get involved in setting policy for our Academy.

    Third, how can we live better?

    • Body, mind and spirit.
    • If we make a conscious decision each day to live better, it helps replenish our reserves.
    • Our Academy provides resources to help us live better and focus on our well-being (and continues to add more), so I encourage you to take advantage of those.

    You may have caught my emphasis on advocacy and our collective voice. There are a number of advocacy priorities we are working on for you.

    The most important one at the moment is the 2023 Medicare physician fee schedule, which will reduce payments, affecting family physicians. We are urging Congress to avert the cuts that will go into effect on January 1 and to implement long-term Medicare physician payment reform.

    You can also get involved by visiting the Advocacy section on aafp.org and click on “Join the Academy: Speak out Now” and you’ll find info on how to speak out about the fee schedule and other important topics. Note that there is some good news in the proposal which we advocated for.

    Your voice is also important in shaping the work of our Academy. Your input helps us understand how to best serve you, and this year’s Member Satisfaction Survey reaffirmed our three-year plan, which you see here. I’d like to highlight that diversity, equity and inclusion is woven throughout all of our work.

    Let us remember why we went into this specialty. Regardless of color, gender, race, ethnicity, ability, religion, sexual orientation or political affiliation, we are all current or future family physicians. We are united here by this singular choice: to care for our patients, communities and families.

    We’ve all had our ups and downs — especially over the last few years.

    I stay positive because of my faith, the support of my family and friends, and my own personal commitment for a better tomorrow.

    So, as I close, let me say this: I encourage each of you to take that first step, even when it seems impossible.

    If it’s in line with your personal mission, say OK.

    Students and residents, you have a superpower because you are our future. We will do our best to support you to ensure your success. Use this power wisely.

    My hope is that all of you will join me on this journey where we can all

    • Be better,
    • Do better, and
    • Live better.

    Family Medicine, you’ve got this.

    Thank you.