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Monday Mar 09, 2020

AAFP Goals Support Award-winning Primary Care From FPs

As the gray chill of winter blanketed the country earlier this year, so did anticipation of the major entertainment awards. As I was watching the 62nd Grammy Awards in January, I heard someone refer to the singer John Legend (who hails from my home state, Ohio) as an EGOT. Only 15 artists have ever become members of that rarified club, having won competitive categories for Emmy, Grammy, Oscar and Tony awards. These artists honed their diverse talents to demonstrate excellence in television, sound, motion pictures and live stage performance.  

[strategy compass concept]

Fast forward to the 92nd Academy Awards in February. While watching the Oscars, I reflected on the many events I had already attended on behalf of the AAFP in 2020. One reoccurring theme at several of these venues was hearing comments about the four cardinal "Cs" of primary care: first contact, coordination, comprehensiveness and continuity. This concept was popularized by the late Barbara Starfield, M.D., M.P.H., in her 1992 book Primary Care: Concept, Evaluation and Policy.

During a commercial break, thoughts of the EGOT club and the four Cs of primary care collided in my consciousness. If a physician could achieve recognized excellence in all four Cs of primary care, it would be our equivalent to the EGOT club. Let's take a closer look at this idea.

The Emmy -- Recognizes excellence in television. Many of our favorite television memories arise from characters who we watched evolve, grow older and, in some cases, get dramatically written out of a TV series. These cherished TV experiences earned some shows a seemingly continuous presence in U.S. households. Interestingly, this aligns with one of the AAFP's strategic objectives: Equip members with the clinical expertise to improve individual and population health. Like our favorite TV shows, the family physician is the only medical professional who is continuously available for every member of a household throughout multiple channels -- or stages -- of life. The AAFP provides members with broad-scope, personalized learning opportunities that further enhance our clinical expertise so we can keep pace with shifting needs.

The Grammy -- Awarded for achievements in sound and communication. Most of us can recall spending hours listening to our favorite songs or musical groups. The rhythm of these songs lifted our spirits, while the lyrics inspired us to dream differently about the world surrounding us. As I watched the Grammys, I witnessed a diverse array of musical artists whose music spanned every decade of my life. The production caused me to think of another strategic objective of the AAFP: Grow a diverse family physician workforce. We're working to develop communication strategies that drive awareness of diversity in family medicine. The AAFP's Center for Diversity and Health Equity has developed tools to increase member awareness of the communities that need our professional services and leadership. The EveryOne Project Toolkit and the new Implicit Bias Training Guide are just two examples of AAFP tools that incorporate communication we must learn to use effectively and that ensure the family medicine workforce is coordinated with community needs.

The Oscar -- Awarded for outstanding artistic and technical achievements in film. Unlike other forms of entertainment, a movie can tell a story by using a comprehensive tapestry of media. When well executed, this artform inspires people to invest dollars to sit in the dark for two hours watching cinematic creations. I equate this with yet another AAFP strategic objective: Support and sustain comprehensive family medicine practices. The AAFP advocates for payment reform that will result in a greater national investment in comprehensive primary care. Comprehensiveness is the center-stage element of the four Cs of primary care. An award-winning legislative achievement for our country would be action that ensures primary care receives at least 15% of the annual health care spend by federal, state and private-sector payers.

The Tony -- Recognizes excellence in live performances in Broadway theater. It wasn't until I saw my first live musical that I realized listening to recordings of musical soundtracks was a poor substitute for the real thing. Case in point: While I enjoyed the soundtrack to the musical Hamilton, it couldn't include the jaw-dropping visual stage production I witnessed when I saw the show in Chicago. The character Hamilton sings in the play, "I've got to be in the room where it happens." In the specialty of family medicine, it is vital that we be in the room where things happen. To achieve Dr. Starfield's primary care concept of first contact, we must conquer another AAFP strategic objective: Reduce administrative complexity. To ensure AAFP members are staying in the exam rooms where we make positive health care outcomes happen, we are working to reduce the administrative complexities that are driving a wedge between the patient and the physician. Administrative functions that distract our members from patient care activities or do not add value to the patient/physician experience must be eliminated.

Becoming a member of the Primary Care Four Cs Club is a heavy lift for any of us. It takes superhuman effort to achieve all four -- or even one -- of the cardinal Cs. However, each element is worthy of our individual and collective pursuit. We will not achieve all four by merely demanding we do so. We will succeed by focusing a spotlight on the strategic value of center-stage primary care for a nation in need of health care solutions. The presence of family physicians who provide full-scope primary care to their communities is the secret sauce necessary to cure this nation's health care dilemma.

During our relatively brief appearance in the stream of human existence, we each desire to live a healthy and productive life. There is good evidence that having a family physician helps us achieve that. I encourage every AAFP member to remain or become a member of the Four Cs Club. When we do, we achieve primary care's EGOT equivalent.

And the winner is … patients who choose family physicians as their personal physicians.

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

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