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Monday Sep 23, 2013

Family Medicine on the Right Course

Flight has always been a passion of mine, especially antique aircraft. So when I spoke to our Congress of Delegates last year in Philadelphia about preparing for my year as AAFP president, I compared it to planning an airplane flight.

A pilot or a leader takes the same three essential steps to prepare for a successful flight:

  • the preflight check  to understand the state of the plane, or in this case, the organization;
  • the weather forecast, to understand the challenges ahead; and
  • the flight plan, to set a course for the intended destination.

After a year that included state chapter meetings, speaking with our nation’s private payers, lobbying trips to Washington, meeting with other national and international primary care groups, and much more (190 days on the road in all), it's time to close my flight plan.

And just as at the end of any successful flight, it's time to perform a flight review.

How did family medicine and our Academy do this year in planning for our flight? Are we on the right course for family medicine and for our country?

Reviewing some of the highlights of the past year will show that our organization is strong and on the right track.

The AAFP now has 110,600 members, and our ranks are growing in every category: practicing family physicians, students and residents. In the National Resident Matching Program, the number of medical students choosing family medicine increased for the fourth consecutive year More U.S. seniors matched to family medicine than in any year in more than a decade.

Interest in family medicine is growing among the public as well. We have an outstanding public relations staff. This past year, our Academy placed 8,768 stories about health and family medicine in the media, doubling our media presence in just three years. This year alone, I participated in roughly 200 media interviews -- resulting in nearly 800 print, online and broadcast placements -- on topics including clinical issues, payment for primary care, graduate medical education and workforce. These opportunities help us tell family medicine's story, not only to consumers but also to payers and policy makers.

On a personal note, one of my proudest moments this year was celebrating the 25th anniversary of Tar Wars, the tobacco-free education program for children that I co-founded as a resident in 1988. More than 9 million children have heard the Academy's message worldwide.

And how was our weather forecast -- the challenges that we faced for the year?

During last year’s Congress of Delegates, the forecast -- at least for the short term -- was for stormy weather. The Supreme Court had just upheld the Patient Protection and Affordable Care Act, but a contentious presidential election was yet to come.

     With President Obama's reelection, health care reform is moving forward. The ACA may be imperfect, but there are provisions in the law that will benefit our patients and our practices:

  • increasing the number of Americans with insurance,
  • eliminating restrictions on pre-existing conditions,
  • moving our health care system to one that values primary care and
  • taking the first steps on creating the right health care workforce.

Our Academy’s role in health care reform is to actively participate in the rule-writing and implementation of the parts of the ACA that work and to actively advocate for improvements where needed, all the while defending the best interests of family physicians and the patients we serve.

And what is our forecast today?

Clearing skies as the patient-centered medical home model (PCMH) moves from pilot programs to implementation.

New forms of payment for family physicians are occurring across the nation with Medicare’s Comprehensive Primary Care Innovation now up and running. Private insurers are starting to pay for the PCMH with care management fees and incentives for improving quality.

Your Academy also is moving forward on three important efforts to improve the health of our country in the long term: a new Future of Family Medicine project, graduate medical education (GME) reform and addressing the social determinants of health.

A year ago, leaders from the Academy and other family medicine groups were beginning to talk about the possibility of revisiting the now decade-old Future of Family Medicine project. This year, a plan is in placeand we are moving forward with a new Future of Family Medicine project that will redefine the role of the 21st century family physician -- including key attributes and scope of practice -- and ensure family medicine can deliver the workforce to perform this role for the U.S. public. You can expect our report this spring.

In addition, the Institute of Medicine is expected to release a review of the governance and financing of graduate medical education in early 2014. That report, which was requested by Congress, should prompt legislative reform, and it will build on momentum from a recently released Council on Graduate Medical Education (COGME) report. The visionary 21st COGME report calls for Congress to increase funding to support 3,000 more graduates per year and to prioritize GME funding based on our country’s workforce needs, specifically calling for more physicians in family medicine and other high priority specialties.

And the movement to integrate primary care and public health is picking up steam, a move that has potential to greatly improve population health for the country overall. For the first time, the Academy has now included the social determinants of health and health equity as part of our new strategic plan

So how did we do with our flight plan?

It has been a great year for family medicine and for your Academy. Though we have not yet reached our destination, we are on the right course and moving forward.

Our heading is true.

Thank you for the privilege of being your president this past year. It has been the flight of a lifetime.

Jeff Cain, M.D., is President of the AAFP.

Posted at 11:57AM Sep 23, 2013 by Jeffrey Cain, M.D.

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