2022 NCCL

Delegates Take Action on Future of Family Medicine

May 25, 2022, 10:27 a.m. News Staff — More than 200 family physicians from across the country came together in Kansas City, Mo., April 28-30 to address issues important to the specialty at the first in-person meeting of the National Conference of Constituency Leaders since the beginning of the COVID-19 pandemic.

One substitute resolution asked the AAFP to advocate against prior authorizations and update its existing prior authorization policy “to include specific medications that lose efficacy or increase risk for patients if not given in a timely manner.” And a substitute resolution asked the Academy to lobby insurers to notify physicians when new plans are created, “so physicians have the opportunity to participate in those new plans without recredentialing.”

Other measures delegates adopted included asking the AAFP to

• work with the American College of Preventive Medicine and the American College of Lifestyle Medicine to advocate for insurance coverage of lifestyle medicine  prescriptions;
• back state legislation protecting patients on HIV-preventive and other medications, and those with positive genetics for potential future health problems, from insurance and claims disqualification;
• amend Academy opposition to deferrals and bans on blood donation by men who have sex with men to include sperm donation; and
• update practice management resources to include a clinical leadership toolkit “specifically addressing collaborative practice with non-physician providers.”

Organization & Finance

Delegates took up several issues from the Reference Committee on Organization & Finance, including a move to help patients understand the high level of health care that family physicians provide.

Supporters of that measure said much of the public is not aware of “the qualitative differences between family physicians and nonphysicians,” and noted that some nonphysician specialties publicly suggest that they can effectively replace physicians at a lower cost. Other FPs cautioned that such a measure should be crafted carefully to avoid harming the working relationships that family physicians have built with their nonphysician team members. Speakers also noted that the AAFP already works to highlight the comprehensive care that members provide.

Ultimately, delegates adopted a substitute resolution asking the Academy to develop public-facing advertising and PR campaigns “that highlight the comprehensive training of family physicians, as well as the complexity and high quality of the evidence-based care they provide.”

Delegates also voted to ask the AAFP to

• develop additional anti-racism CME;
• advocate for CMS to publicly release payment information broken down by physician gender, experience, geography, work hours and scope; and
• investigate the need for a member constituency to represent family physicians with disabilities.

Health of the Public and Science

Resolutions and substitute resolutions from the Reference Committee on Health of the Public & Science that delegates adopted included one asking the AAFP to develop a pediatric psychiatric toolkit of resources and best practices for family physicians. The measure also asked the Academy to financially support a training curriculum for family medicine residencies to increase education in child psychiatry as well as CME resources on child psychiatry for FPs already in practice.

Other action delegates took on measures from the reference committee included asking the AAFP to

• create a roadmap to help state chapters collaborate with their state health departments on allowing Medicaid managed care companies to use “in lieu of services” funding to address social determinants of health and health equity;
• support comprehensive reimbursement for screening, evaluation, counseling and treatment of SDOH;
• support education and advocacy focused on the increased risk of postpartum morbidity and mortality associated with depression and cardiovascular events, as well as research on why the United States has the highest maternal mortality rate of any industrialized nation; and
• advocate to remove the three-month deferral period for people from sexual and gender minorities to donate blood products.

Education

Delegates adopted a resolution from the Reference Committee on Education that asked the Academy to help improve education for students, residents and physicians regarding the care of LGBTQ+ patients.

Delegates also adopted a resolution from the reference committee that asked the AAFP to create CME on the diagnosis and treatment of severe and treatment-resistant mental health disorders in family medicine clinics. Supporters of the resolution noted “the lack of existing education and the need to address this deficit.”

Other action delegates adopted including asking the AAFP to

• create a best practices toolkit for implementing pipeline programs and facilitate mentorship programs focused on the enrichment of K-12 youth; and
• explore pathways for unmatched medical graduates interested in family medicine to gain postgraduate training before reentering the Match.

Advocacy

Measures that delegates adopted from the Reference Committee on Advocacy included one urging the Academy to lobby for “permanent reimbursement for all forms of remote health care communications within an established patient-care relationship via any form of digital communication.”

Delegates also adopted other measures from the references committee, including resolutions or substitute resolutions that asked the AAFP to

• investigate the financial and administrative burdens, and the disruptions to the physician-patient relationship, stemming from insurance-contract enforcement;
• ask FamMedPAC to review its approach to supporting legislators whose votes or public stances fail to align with the AAFP’s policy goals; and
• advocate for improved workforce diversity via debt relief for at risk and underrepresented family medicine students.