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Wednesday Jan 02, 2019

Physician Leaders Can't Wait for Squeaks to Turn Into Clunks

It was the summer of 2014, and I was driving my classic 1966 Wimbledon-white convertible Ford Mustang to the 50th Anniversary Mustang Celebration in Charlotte, N.C. Just before reaching the Chillicothe, Ohio, exit on U.S. Route 35, I began to hear an odd squeak from beneath the vehicle.

[vehicle being loaded onto tow truck]

It's not unusual to hear a chorus of pings, pops and grunts while driving a 48-year-old car, but this particular squeak sounded more urgent. The squeak's crescendo eventually yielded to a groan that abruptly ended my journey with a final, loud metallic clunk. The subtle squeak I had ignored as I began my journey was the sound of the car's crankshaft linkages (which connect the engine to the rear wheels) breaking. My Mustang no longer had the capacity to gallop because the wheels had structurally disengaged from the engine.

In my haste to reach my short-term destination, I had failed to heed the long-term needs of my treasured car.

With 131,400 members, the AAFP's leadership is challenged on a daily basis to listen to the opinions and insights of family physicians with a diverse array of professional concerns. We read your opinions in the comments on AAFP News stories and blogs. We receive valuable input through the AAFP commissions and hear your concerns at the Academy's national and chapter meetings.

These concerns cover a wide range of issues: physician payment reform, social awareness of the value of family medicine as a specialty, medical student specialty choice, social justice, advocacy and political engagement, physician lifestyle enhancement, practice transformation, and more.

The AAFP has established strategic goals and objectives to direct us on our road to the future, but we also continue to listen to the diverse voices of members so we can address their other urgent needs. Our challenge is learning how to best hear and respond to these urgencies before our forward progress is halted.

The mission of the AAFP is to improve the health of patients, families and communities by serving the needs of members with professionalism and creativity. Every year, the AAFP uses a variety of marketing and communication methods to correct course on our strategic priorities so we can best fulfill our mission. The most familiar of these methods is our annual AAFP Member Satisfaction Survey. By effectively responding to the collective needs of our members, we are better positioned to improve the health of patients, families and the communities we serve.

However, in this age of 24/7 media and persistent information overload, it has become increasingly difficult to isolate the background noise from the justifiably urgent messages signaled by our membership. As AAFP leaders, we can ill afford to dismiss any member's voice as just being a squeaky wheel. There is always a sentinel event that made the wheel squeak.

Although there are no easy answers to the complex matrix of payment and delivery of service in the U.S. health care system, we must -- as our mission states -- be creative in our ability to hear the voices of our fellow family physicians with greater fidelity.

Recently, I was discussing the topic of direct primary care (DPC) with an individual who had attended the 2018 DPC Summit(www.dpcsummit.org) in Indianapolis. Without prompting, he acknowledged his appreciation of the AAFP for hosting such a beneficial event for members who are seeking alternatives to a traditional primary care practice. He went on to lament that he only wished the AAFP could assist members in migrating to a DPC practice by creating a DPC toolkit. I immediately took out my phone and directed him to that very toolkit.

The DPC Summit and this toolkit both had their genesis from members who had previously spoken to the AAFP with a practical voice of urgency. The deeper question here was why this member was not aware of the existence of the toolkit he needed. How could the AAFP do a better job showcasing the vast array of member opportunities, services and resources we have to offer?

While we're on the topic, it's worth noting -- in case you missed it -- that the AAFP recently highlighted resources related to issues such as physician well-being, and helping patients find community services(familydoctor.org) in an email to all members.

Although it would be impossible to make constant strategic priority adjustments based on every member's unique request, we must remain nimble in our capacity to communicate with our membership and respond to their needs appropriately. To better accomplish this, the AAFP Board of Directors has approved funding to significantly upgrade the Academy's website and optimize our overall digital presence.

There are no simple answers to how we can best arrive at the day when our AAFP mission will be fulfilled. Our destination is an era in which everyone in our country has the capacity to receive appropriate and affordable health care services. If we are willing to lead the way, our specialty's social worth will increase exponentially. As we continue this journey, we must always be listening closely for the crescendo of voices from members who have urgent professional needs requiring our immediate attention.

If we fail to provide members with effective tools, their efforts to communicate these needs will eventually cease. Silence does not always indicate a remedy. Those who lead do not want to look back only to discover that the reason they don't hear the squeaky wheel anymore is that the engine is no longer connected to the rubber that meets the road.

Wishing everyone a happy and prosperous new year!

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

Posted at 03:18PM Jan 02, 2019 by Gary LeRoy, M.D.

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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.