2016 NCCL

Diversity, Child Care, Violence Draw Delegates' Focus

May 09, 2016 01:00 pm Richard Espinoza Kansas City, Mo. –

Drawing physicians from diverse backgrounds into family medicine, ensuring they can care for their children and keeping them safe in their practices were key issues taken up by the Reference Committee on Organization and Finance during the 2016 National Conference of Constituency Leaders (NCCL) held here May 5-7.

Kisha Davis, M.D., M.P.H., tells the Reference Committee on Organization and Finance that diverse communities need family physicians from diverse backgrounds.

Delegates adopted several resolutions to advance those goals through research and advocacy during the business session on the final day of the conference.

One of the resolutions, titled "Upgrading to Diversity and Inclusion Version 3.0," echoed language from the opening plenary address on promoting diversity through leadership by Marc Nivet, Ed.D., M.B.A.

Family medicine needs physicians from many backgrounds so diverse communities can receive the best care, said Kisha Davis, M.D., M.P.H., a gay, lesbian, bisexual and transgender (GLBT) delegation representative from North Potomac, Md., and an author of the resolution.

"How do we move from an organization that recognizes the importance of diversity to an organization that really has diversity and inclusion at its core?" Davis asked.

Story Highlights
  • Delegates at the 2016 National Conference of Constituency Leaders adopted several resolutions calling for research and advocacy to encourage people from diverse backgrounds to become family physicians and keep them safe.
  • Diversity is important so patients can be cared for by physicians who understand their cultures, some delegates said.
  • Delegates want to encourage chapters to work on the state level to protect physicians from violence.

Part of the solution could come from a task force on diversity and inclusion that delegates asked the AAFP to create. The resolution proposed to task the group with developing diversity metrics, as well as processes to assess and projects to encourage diversity.

Delegates also adopted a substitute resolution meant to increase the pipeline of family physicians from underrepresented demographic groups. Supporters of the resolution discussed the benefits of having family physicians with deep cultural understanding of the communities they work in.

"If we want to address health disparities, we need to increase the number of underrepresented minority physicians in the pipeline," said Syeachia Dennis, M.D., a minority delegate from Tulsa, Okla.

Already, the AAFP is undertaking work with other organizations through Family Medicine for America's Health,(fmahealth.org) as well as other partnerships to improve national diversity outreach. The substitute resolution adopted during the business session asked the Academy to communicate such efforts annually and investigate the development of objective criteria.

Other adopted resolutions focused on gathering data about diversity among family physicians and their patients. Two of these call on the AAFP to move collection of race, ethnicity, gender identity and sexual orientation data to its primary census survey and to publicly publish the aggregate summary data.

LeeAnna Muzquiz, M.D., a minority delegate from Polson, Mont., said the race and ethnicity data could help align diversity of AAFP leadership with that of members and their patients. Joe Freund, M.D., a GLBT delegate from Des Moines, Iowa, said accurate data on gender identity and sexual orientation are vital to ensure GLBT members have a voice.

Similar information about patients also is important, delegates said. They adopted a substitute resolution calling on the AAFP to strongly recommend that family physicians collect data on the sexual orientation and gender identity of their patients so they can identify individual health needs and address health disparities.

Support for FPs' Families

Delegates discussed the need to ensure that careers in family medicine and AAFP meetings accommodate physicians who are parents.

Sarah Metzger, M.D., speaks in support of a resolution for better parental leave for family physicians as she holds her baby daughter, Zelie.

Meghan Lelonek, M.D., a new physician delegate from Bellingham, Wash., explained why paid parental leave is especially important to family physicians. "We realize that the health of our personal families and our own personal wellness as physicians is crucial in the wellness of our patients," she said.

Delegates adopted a substitute resolution asking the Academy to support at least 12 weeks of paid parental leave for family physicians and residents, with an optional unpaid extension, and to investigate relationships with insurance programs that could provide short-term paid parental leave insurance.

Delegates also adopted a substitute measure calling on the Academy to offer members information about interactive, engaging child care services at its national meetings to make it easier for more members to participate.

Workplace Violence

Several delegates described fear and violence they have faced in their practices, ranging from a patient who had what turned out to be a toy gun to people carrying real firearms and a crossbow. Some states have made it a felony to assault certain health professionals without extending this protection to physicians.

Lt. Cmdr. Ana Solis, M.D., of Pensacola, Fla., an international medical graduate delegate and member of the Uniformed Services chapter, has seen the difference that such protections make. She said she never is disrespected by her patients in the military because they know they would be punished, but she has been threatened by patients in civilian settings.

"We have to protect each other," said Solis. "We are in a very vulnerable position in ERs and urgent care centers, and also in clinics."

The AAFP already advocates for federal legislation to protect physicians. Delegates adopted a substitute resolution calling on the Academy to encourage chapters to do the same at the state level. Another substitute measure asked the Academy to oppose laws that permit firearms in civilian health care facilities.

Delegates also adopted a resolution asking the Academy to study and recommend ways to address workplace violence, including bullying and other actions that degrade, alienate and isolate physicians.

"We really need to know what the numbers are and where we are so we can aim correctly at helping each other get through these issues," said Tina Tanner, M.D., a GLBT delegate from Montague, Mich.

NCCL delegates also adopted measures that asked the Academy to

  • identify ICD-10 codes that are related to social determinants of health,
  • adopt people-first language that refers to "patients with obesity" instead of "obese patients" and
  • reaffirm that the AAFP opposes all discrimination in any form.

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