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Wednesday Nov 07, 2018

Embrace Change and Tech to Shape Our Future

"Change is like an ever-present life partner who I despise when it takes me from my comfort zone but love when it reveals my potential to become a better person."

I pause to reflect and collect my thoughts before addressing the 2018 Congress of Delegates as the AAFP's new president-elect on Oct. 10.

These were the final words I shared on the morning of Oct. 10 with AAFP members, staff and guests who attended the 2018 Congress of Delegates in New Orleans. Minutes later, I was honored to take the oath of office as your president-elect. In a surreal fashion, time seemed to halt as I raised my hand and glanced out over the diverse audience of family physicians representing chapters from every state, as well as U.S. territories and Washington, D.C. In a brief moment of personal reflection, the words on the Great Seal of the United States, E pluribus unum, flashed through the churning sea of my prideful thoughts.

E pluribus unum -- Out of many, one.

In 1776, this 13-letter motto was suggested by a committee charged with developing a seal for the new nation being forged during the American Revolution. Although the Latin phrase originated hundreds of years before the formation of the United States, it is now emblematic of the American dream. The strength of our nation, or any organization, is in its capacity to harness the talents of its many citizens or members to change the course of human events with a shared vision of a better future.

Our inherent desire to become a better society for all people often stands in conflict with personal desire to resist change. It is human nature to long for the halcyon days of old when the status quo sustained our self-selected comfort zones. But change is a reliable constant. It is a life partner who will push us from our comfort zones by way of social unrest, disruptive technology, natural disaster, military conflict, pandemic disease, spiritual revelation or the specter of death. We the people evolve when a critical mass of concerned people (the many) work together for a common cause in response to the pressure of a changing social environment.

Family medicine is responding to dynamic social changes in a health care system struggling to define its direction in the early stages of the 21st century. Emerging technologies combined with social media and direct-to-consumer promotions now offer patients alternatives to the traditional patient-physician medical model. This consumer-oriented health care environment is ripe for exploitation by unproven claims of superior medical outcomes by profit-focused commercial entities. Several of these providers of convenience care, alternative self-remedies and health monitoring devices dress up their products in media hype, popular technology and promises of instant gratification. We must be prepared to assist our patients in navigating this ocean of appropriate and inappropriate consumer medical services.

It is logical for those of us who actually have earned medical degrees to exalt the wisdom of the genuine art of medicine. The specialty of family medicine must also resist being characterized as the low-hanging fruit of the medical profession, ripe for picking by commercial entities seeking to grab a significant portion of our nation's second largest expenditure (surpassed only by military spending).

If we feel threatened by the growing shadow of commercial entities who claim the ability to do what we do better, then we must prove their claims unjustified with factual evidence -- not simply words of rebuke. We must provide the public with an intentional menu of value-based services that demonstrate our intrinsic benefit to society. As the personal physicians for Americans, we family physicians have the training and cognitive skills to provide our communities with continuous, comprehensive and coordinated medical care by using appropriate contemporary technologies to enhance the value of each patient encounter.

Although at times it seems as though everyone with a new smartphone app or a major financial investment in the medical industry is attempting to supplant family physicians with legislation and/or commercial strategies, we can head them off by nimbly embracing select leading-edge technologies. I foresee our members pioneering new models of practice using augmented digital technologies to facilitate physician-patient interactions during and between office visits.

This is not simply a fanciful dream for our future. In October, the AAFP Board of Directors approved a special project to establish a program focused on driving innovation with the latest health information technologies, such as cloud, mobile and artificial intelligence/machine learning, to optimize the family medicine experience. The AAFP will be working in collaboration with recognized thought leaders in the technology industry to steer us toward innovative ideas for reducing clinical administrative burden, increasing our ability to receive value-based payments and advancing technologies to positively transform what it means to be a family physician.

I will seek opportunities during the next three years to communicate about innovative ideas with each of you using new technologies and old methods. I challenge you to write back with your own ideas and dreams.

The late comedian Joan Rivers used to preface her routines by asking, "Can we talk?" The AAFP wants to talk with you, not at you, by whatever means you prefer. It is my personal desire that out of a diverse choir, one resounding call for change will be heard by a society eager to become better at providing life-enhancing health care, not simply for the majority but for all.

I hope our new societal motto for the health of our public will soon be E pluribus curae: Out of many, care -- care for all.

Gary LeRoy, M.D., is president-elect of the AAFP.

Posted at 12:19PM Nov 07, 2018 by Gary LeRoy, M.D.

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