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Tuesday Sep 06, 2016

What I Know Now, and What Lies Ahead

My term as AAFP Board chair will end Sept. 21 when the Congress of Delegates adjourns in Orlando, Fla. As that date quickly approaches, I find myself reflecting on the six years that I have represented family physicians and our specialty as a member of the Academy's Board of Directors.

I've learned a great deal in those six years, traveling the country to meet with members, media, payers and policymakers. Here is a look at some important things I now know and a few things I don't know -- yet.

Here I am testifying about issues related to electronic health records during a hearing of the Senate Committee on Health, Education, Labor and Pensions.

What I know is that representing family medicine has been a wonderful experience. Knowing the good work family physicians do every day to care for patients made the job of talking to reporters and legislators easy. We represent not only physicians but also patients, and our patient stories can be incredibly powerful when we tie them to a specific health care issue.

Knowing that our membership -- 124,900 and growing -- had my back gave me a strong voice, whether it was in front of a microphone during media interviews or on Capitol Hill. The good, vital work of so many family physicians gave me a seat at the table, and our input is credible and valued.

I worked hard to gain your trust and confidence, and knowing I had it gave me strength even when the going got tough. I know it was a good day when we laid the flawed Medicare sustainable growth rate to rest after 17 patches and more than a decade of threatened double-digit payment cuts.

I don't know exactly how the Medicare Access and CHIP Reauthorization Act (MACRA) will evolve, but I do know the AAFP is providing feedback and working to ensure that the new law is implemented in the best way possible for primary care.

Health care is changing. It is moving from a fragmented, volume-based, fee-for-service world to a value-based payment and delivery system. I know this creates huge opportunity for family physicians because we deliver high-quality, cost-effective care. That is the answer to our nation's health care delivery question.

I don't know how value-based care will be defined by payers and policymakers. Will it be a complex set of rules and regulations that takes joy out of practice? Rest assured, the Academy is fighting to prevent that, making the voice of family physicians heard and working to keep regulations simple and manageable. Let the focus be on patient care.

What I know is having an adequate family physician workforce is key to the success of MACRA and a value-based system. Other providers with far less training will step forward -- and have -- to say they can fill the void in the physician workforce. They can't. They aren't family physicians.

I know the number of students matching into family medicine has increased seven years in a row. Will that tide rise high enough to fill a gaping shortage of primary care physicians? We know it won't without reform of the graduate medical education system  because there aren't enough family medicine residency positions to produce the workforce needed.

The Academy is working for that change while also building student interest in our specialty. On that front, there are encouraging signs that we are moving in the right direction. This year's National Conference of Family Medicine Residents and Medical Students set records, with final numbers showing 4,798 participants attended the meeting, including 1,326 students and 1,207 residents.

Meanwhile, our student membership has swelled to 32,000. That includes 31.8 percent of all U.S. allopathic medical students and 16.2 percent of osteopathic students.

What I know is that I have experienced great personal growth as a result of being elected to the AAFP Board of Directors six years ago. My granddaughter Shiloh was born on the second day of my first Board meeting. She was a passionate, babbling newborn with a lot to say, but she was unfocused and hard to understand -- not unlike me during my first Board meeting! But over time, she has grown to become a focused, articulate and still passionate kindergartener who knows she has the unconditional acceptance of her grandfather. Again, that's not unlike me developing into a laser-focused Academy officer thanks to the support of our members.

Finally, I know I am excited to bring my full attention back to providing comprehensive, full-scope family medicine at my practice in rural Nebraska. I also know family medicine is a wonderful profession. No, a calling. I wouldn't want to do anything else.

Thanks to all for your support.

Robert Wergin, M.D., is Board chair of the AAFP.

Posted at 12:39PM Sep 06, 2016 by Robert Wergin, M.D.

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