During the 2018 National Conference of Constituency Leaders (NCCL) held here April 26-28, AAFP members from the five constituency groups -- women; minorities; new physicians; international medical graduates (IMGs); and lesbian, gay, bisexual and transgender (LGBT) physicians and those supportive of LGBT issues -- acted on resolutions considered by the Reference Committee on Education.
During the Reference Committee on Education hearing, Casey Henritz, D.O., a new physician delegate from Atlanta, recommends engaging with children earlier in middle school, high school and college to get them into the family medicine pipeline.
Resolutions discussed during the April 27 committee hearing included those promoting family medicine to under-represented populations, educating family physicians on gaps in treating minorities during the opioid epidemic, and increasing the number of topics on women's reproductive health at the AAFP's Family Medicine Experience (FMX).
Promoting Family Medicine to Under-Represented Populations
One substitute resolution adopted as amended during the business session on April 28 requested that the AAFP and the AAFP Foundation collaborate on initiatives to engage middle and high school student populations that are under-represented in family medicine through programs that promote the specialty.
Furthermore, the resolution asked the Academy to amend its policy on medical schools, minority and women representation in medicine to broaden its position to stimulate interest in medical careers in these under-represented populations.
Co-author Casey Henritz, D.O., a new physician delegate from Atlanta, said it's common knowledge that there's a physician shortage in family medicine.
- One substitute resolution that emerged from the Reference Committee on Education at the 2018 National Conference of Constituency Leaders aims at more engagement of middle and high school student populations that are under-represented in family medicine.
- Another substitute resolution asked the AAFP to develop an awareness campaign of the gap in treatment for opioid addiction in the minority population.
- A substitute resolution that was adopted as amended called for differentiation at FMX between reproductive health and women's health.
"One of the best ways we can remedy that is engaging with children earlier in middle school, high school and college to get them into the family medicine pipeline," she said. "This is especially true for those minorities and girls who might not know they have the potential to do these things."
Joseph Nichols, M.D., M.P.H., a new physician delegate from Baltimore, testified that he was a product of just such a program in South Texas -- MedEd(uthscsa.edu) at the University of Texas Health Science Center at San Antonio.
He said the university was looking to increase the number of Hispanic students in its medical school classes, so it started working with high schools in heavily Hispanic areas near the Mexican border with Texas. This exposed students to family medicine and other professions such as veterinary medicine, pharmacy, optometry and psychology.
"Most of us got eight-year scholarships," Nichols said. "From the moment you graduated high school, you had a seat in medical school waiting for you with a full scholarship. All you had to do was make a minimum MCAT score and GPA."
"A funny thing happened: 47 schools in the state of Texas now have some version of this program. We are the No. 1 state for our medical education pipeline."
Gaps in Treating Minorities for Opioid Addiction
A substitute resolution that passed addressed another timely topic, asking the AAFP to develop an awareness campaign to educate physicians and physicians-in-training of the gap in treatment for opioid addiction in the minority population.
Additionally, the resolution called on the Academy to educate members on best practices and collaborative efforts that are effective in treating opioid use disorder in the minority population.
Finally, the substitute resolution requested the AAFP update its chronic pain management toolkit to incorporate health equity tools that focus on treating the minority population during the opioid epidemic.
Co-author Karen Smith, M.D., a minority delegate from Raeford, N.C., said this population has been undertreated for opioid use disorder, creating gaps in care.
"The minority population has seen increased mortality due to the onset and increased use of fentanyl as well as heroin," she said. "It's been recognized that a multifaceted approach to this issue is necessary.
"We ask the AAFP to recognize the need to incorporate a different type of approach for addressing the gaps in care for the minority population regarding the opioid epidemic."
Emily Guh, M.D., a general registrant from San Francisco, explains that as a new physician, she doesn't have enough vacation time to go to multiple CME events each year, so she needs it to be provided in one place.
Reproductive Health Topics at FMX
A substitute resolution that was adopted as amended during the business session called on the AAFP to direct its curriculum advisory panel for FMX to differentiate reproductive health from women's health by creating separate categories for the two topics.
In addition, the resolution asked the Academy and its curriculum advisory panel to openly publish the percentage allocations of session topic categories for all national AAFP live and online continuing medical education activities.
Co-author Emily Guh, M.D., a general registrant from San Francisco, said as a new physician, she doesn't have enough vacation time to go to multiple CME events each year, so she needs it provided in one place.
"I don't think that a 4-percent allocation at FMX for women's reproductive health is really enough to help me best provide care for my patients at reproductive age," she said.
Asim Jaffer, M.D., an IMG delegate from Peoria, Ill., spoke as the chair of the FMX advisory board and explained that there's a thorough process for selecting the CME content for the sessions offered. He worried that this resolution could unfairly sway the programming in one direction at the expense of other areas.
"Things considered in this process include learning gaps for family physicians, needs assessments, what constitutes board certification and evaluations from previous FMX sessions," he said. "The beauty and the beast of family medicine is its broad scope. So, we won't be able to hit every topic at every conference."
Among additional measures considered by the reference committee, NCCL delegates adopted resolutions that asked the Academy to
- advocate for adequate time for both direct and indirect care, and improved work-life balance;
- support and collaborate on legislative initiatives to address the high rates and disparities of maternal mortality in the United States;
- provide results of a parental leave policy survey that members could use to negotiate employment contracts;
- conduct an assessment of IMG members to better understand their unique needs, including with H1B and J-1 visas; and
- add resources on the AAFP website about long-acting, reversible contraception.
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