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Monday Sep 11, 2017

Everyone Should Realize FPs Are the Quarterbacks of Medicine

Most people who know me know that two of my passions (aside from family) are history and Alabama football. In this post, I'll touch on both.

Family physicians provide comprehensive care for patients of both genders and all ages.

The college football season started for most teams on Sept. 2, and few players in my state will get more scrutiny, more fan attention or more press coverage this fall than Alabama's Jalen Hurts. Last year, Hurts became the first true freshman to start at quarterback for the Crimson Tide in more than three decades. He responded with more than 2,700 yards passing and 23 touchdowns and ran for another 954 yards and 13 TDs. What will he do for an encore? We'll have to wait and see.

It's often said that quarterbacks get too much credit when their teams win and too much blame when they lose. Certainly, quarterbacks don't win or lose on their own. They need linemen to block the defense, receivers to catch their passes and running backs to carry the ball. But it is the quarterback who analyzes the defense before each snap, executes each play and leads his team on the field. Accordingly, it is the quarterback who often faces the harshest criticism or highest praise.

The same is true in business. CEOs delegate financial issues to their chief financial officers, legal matters to attorneys and so on. But it often is the CEO who reaps the biggest reward -- or takes the biggest fall -- based on an organization's performance.

So why is it that in medicine, the physicians who have the most lasting and profound effect on patients' health aren't recognized as the leaders we are? And what could possibly be the rationale for relegating us to the lower tier of the pay scale? Family physicians provide continuous, comprehensive care to everyone across the entire life span. We deliver babies, help patients plan for end-of-life care and offer so much in between. Yet too many payers and policymakers fail to appreciate the vital role we play in the health care system.

According to a Medscape compensation survey,(www.medscape.com) physicians in four subspecialties -- orthopedics, plastic surgery, cardiology and urology -- made an annual average of $400,000 or more, which is double or nearly double the average for primary care physicians. With all due respect to our subspecialty colleagues, this would be similar to treating a placekicker or a short-yardage fullback like the star of your team. It lacks perspective and appreciation for the importance of prevention, wellness, management of chronic conditions, care coordination and the follow-up needed when our patients do need to see other members of the health care team.

A few months ago, I told you about the 70th anniversary of the AAFP. Our Academy was started after World War II when general practitioners returned to their civilian practices and found they were losing hospital privileges to perform procedures they had done before -- and during -- the war as health care was becoming more specialized. GPs needed a national association that could protect their rights.

Today, the Academy is still fighting that fight, telling our members' stories and educating payers and policymakers about the broad spectrum of care that family physicians provide. We provide holistic care, looking at the whole person rather than that person's various parts. We are the quarterbacks who lead each patient's team.

Unfortunately, there are metrics that can point the finger at us when patients don't fill a prescription or otherwise choose not to follow our advice. But are we fairly compensated for our successes? Are we rewarded for the patients who stop smoking? Those who follow our nutrition and exercise recommendations and lose weight? The ones who are vaccinated?

Not yet, but with your help we will get there.

It has been my privilege to be your president during this 70th anniversary year. I have taken our message forward at every opportunity with legislators, policymakers and members of the media, and I will continue to do so. I encourage you to tell your stories, as well.

Primary care is the foundation on which everything else in health care is built. Spread the word.

John Meigs, M.D., completes his term as AAFP president on Sept. 13. He will serve the next year as Board chair.

Posted at 11:36AM Sep 11, 2017 by John Meigs, M.D.

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