Tuesday Feb 02, 2016
Family Medicine: The Force Awakens
I recently saw the latest Star Wars movie with my family, and I could not help but compare the plight of the Jedi to that of family medicine. With the many challenges facing us as family doctors -- payment reform, endless paperwork, putting patients back at the center of care, electronic health records and recruiting the brightest young family physicians -- it often seems like the good in all we do is menaced by the darkness of partisan politics, back-room lobbying and catering to special interests. But like the young Jedi Knights, if we are attuned to the Force, we can wield its power.
In medicine, the Force is the collective voice that speaks for our patients. Physicians use it when we defy the status quo and pressure the government, insurance companies, hospital corporations and Pharma to heed our concerns because we are the front line of medicine.
In The Force Awakens, we cheered for the Resistance, a group of passionate people who rally together to reclaim the good in their world. In the world of medicine, we got a great start on reclaiming the good when we won repeal of the Medicare sustainable growth rate last year, and CMS' announcement several months later that it plans to end meaningful use as we know it could be a good next step. But it will take determination to keep this momentum going so future payment models and new ways of measuring quality health care support our work as physicians.
Another family physician who covers OB call with me recently said, "I honestly know how much my voice matters. I know that I should be more present advocating on behalf of my patients, but I don't have the energy or the time. I can barely keep afloat in my small, rural practice."
He's been practicing for more than 20 years, and now he feels burdened by meaningless work to the point of exhaustion. He knows there is a sacred component to walking with patients through their important life moments -- a delivery, seeing a child grow to maturity, working through chronic addictions and illness or the end of life -- but he feels pressured to reduce all that to clicking boxes and being "productive." We mustn't allow the business of medicine to pull us from what we as physicians vowed to do, which is care for patients, and we must find the energy to fight for what matters.
I know that the doctors who the AAFP and our sister organizations represent are looking for their representatives to press CMS, Congress and others harder to enact meaningful change. Our practicing physicians deserve it and so do our patients. But success won't come if that burden rests only on the shoulders of a few. Everyone has to play a part to reclaim medicine and resist the bureaucracy that tries to steal the joy of practice from us.
Our members need to become emboldened. Each individual within our own Resistance has a special role to play. If we as family doctors do not speak to our legislators, then we have no ground to stand on. If we do not take the time to educate our communities about the things that make our practice of medicine difficult, then we lose their trust. If we do not continue to press the government by developing new and innovative practice models, then we will continue to fall prey to meaningless bureaucracy.
Our collective voice and our individual stories have weight and meaning. We can become the doctors we wrote about in our medical school personal statements. We have the power and the right to protect our practices, our patients and our joy of medicine. We have to remember that without us, the system of medicine fails. Let us not be bullied.
Colleagues, I urge you to contact your legislators and tell them your story. Stop accepting half-done business deals from the hospitals you work with. Take the time to write to the local paper. Contribute to FamMedPAC so it can continue to back candidates who support family medicine. Most importantly, don’t stop believing in the power we have as healers of our nation.
As a wise woman says in the movie, "Close your eyes. Feel it -- the light. It's always been there. It will guide you."
Marie-Elizabeth Ramas, M.D., is the new physician member of the AAFP Board of Directors.
Posted at 03:42PM Feb 02, 2016 by Marie-Elizabeth Ramas, M.D.