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Tuesday Feb 20, 2018

Part II: Sharing Our Workforce, Clinical Priorities for 2018

"The consideration that human happiness and moral duty are inseparably connected, will always continue to prompt me to promote the progress of the former, by inculcating the practice of the latter."
-- George Washington

In my previous post, I introduced you to a few of the AAFP's legislative and regulatory priorities for 2018. To recap, those priorities mirror our strategic objectives: payment reform, practice transformation, workforce and clinical expertise. This week, I will share highlights of our workforce and clinical expertise priorities. In addition, I will review ways you can engage with us on this important work.  

[physician holding help wanted sign]


Building the family physician workforce is a long-standing policy and advocacy objective of the AAFP and continues to be a focus of our advocacy efforts. Although progress towards comprehensive workforce reforms remains elusive, we have made significant advances in expanding training opportunities for family physicians.

  • Teaching Health Center Graduate Medical Education -- The THCGME program, established as part of the Affordable Care Act in 2010, has emerged as one of the most successful workforce development programs with a proven track record of training family physicians and other primary care physicians. Today, there are 57 THCs training 732primary care residents.

    The AAFP has prioritized the promotion and protection of the program since its inaugural year in 2011. We have worked closely with Congress to secure authorization and funding for the program, while simultaneously working to develop a more stable financing model for the future. The THCGME program was reauthorized in 2015 as part of MACRA, and last week the AAFP played a key role in successfully securing the second reauthorization of the program as part of the Bipartisan Budget Act of 2018. Authorization and funding for the program expire on Oct. 1, 2019.

    Identifying and enacting long-term funding for the THCGME program is a top priority for the AAFP and will continue to be a focal point of our advocacy efforts.

  • Graduate Medical Education Reform -- The AAFP developed a comprehensive GME reform proposal in 2014. The Aligning Resources, Increasing Accountability, and Delivering a Primary Care Physician Workforce for America proposal calls for greater accountability and transparency in our national GME system and an alignment of national investment in meeting the physician workforce needs of the country. The proposal also creates a mechanism to ensure that the training of physicians occurs in the most appropriate settings and not solely in a hospital. My favorite provision of the proposal continues to be our call to "limit payments for direct graduate medical education and indirect graduate medical education to training for first-certificate residency programs," meaning we should stop subsidizing the over-specialization of physicians by cutting off federal funding for fellowship programs.

Clinical Expertise

The AAFP's legislative and regulatory work on the clinical expertise strategic objective largely focuses on the public health work of the CDC and the advancement of research programs at the Agency for Healthcare Research & Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). These entities play an important role in advancing primary care, prevention, public health and the value of family medicine. Sadly, PCORI faces dramatic reductions in financing, and AHRQ may face total elimination.

The AAFP values the important roles each of these entities plays in our health care system, and we are committed to their preservation and future work. Protecting and funding these entities is a legislative priority.

Advocacy Operations

The AAFP's advocacy efforts in Washington, D.C., are built on three pillars -- member engagement, political engagement and direct lobbying. The AAFP has a team of professionals that engage in direct lobbying on behalf of our members, but those efforts rely upon the other two pillars to be fully effective.

The AAFP is recognized as one of the most bipartisan organizations in Washington, D.C. -- a distinction that allows us to effectively advocate on your behalf. In addition, we are highly regarded by both parties as an organization that seeks compromise and offers bipartisan solutions versus political rhetoric.

We are working hard on your behalf, but we are stronger when you engage with us. It is the engagement of family physicians through grassroots and political advocacy that really drives the AAFP's agenda on Capitol Hill and in state capitols across the country.

Here are two ways you can participate.

  • Family Physician Action Network -- Some of you may already be members of the network. Others may be learning of it for the first time. For those who are already engaged, we thank you for your support. For those that are not members but have an interest in becoming more active and effective advocates for family medicine, I urge you to join today.

    The network provides the background information, tools and resources necessary to be a truly informed advocate on behalf of family medicine. You also are invited to participate in briefing calls and webinars on key legislative issues. The network is the group we rely upon to advance our message through grassroots advocacy and I strongly encourage you to become a member today.

  • FamMedPAC -- Engaging in the political process is one of the three pillars of the AAFP advocacy program. Since the establishment of FamMedPAC in 2004, we have experienced incredible support from family physicians year in and year out. As a result, FamMedPAC is one of the most influential health care PACs in Washington, DC.

    However, there is plenty of room for improvement. I encourage all family physicians to participate in FamMedPAC Your participation strengthens our advocacy capabilities and expands our influence. Future growth of FamMedPAC will allow the AAFP to expand its reach and increase its influence when it comes to the political process. This expanded reach will allow us to assist members of Congress who support family medicine and, conversely, try to defeat those who do not stand with us.

Wonk Hard

Feb. 22 is the birthday of our nation's first President (and lead character in one of the greatest GEICO commercials ever(youtu.be)), the Honorable George Washington. It also happens to be the birthday of the late Massachusetts Sen. Edward Kennedy, NBA Hall of Famer Julius (Dr. J) Erving and E.T. star Drew Barrymore. It also happens to be the birthday of my favorite family physician, my father. Now, you might not know that my father became the father of a future family medicine advocate and witty health policy blogger on Feb. 22, and my sister's oldest son was born on the same day several years later. So, as you can see, Feb. 22 is a pretty big deal in my world.

Posted at 08:00AM Feb 20, 2018 by Shawn Martin

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Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.