From the President

Annual 'Report Card' From AAFP Members Provides Guidance for the Future

Fixing Payment Will Be Top Priority

September 25, 2010 03:35 pm Lori Heim, M.D.

We hear you. Thank you. Your voice makes a difference. This is the message I want to convey to each and every one of you who has shared an opinion with us in recent months -- and especially if you participated in the 2010 Member Satisfaction Survey, the capstone of our annual member research program.

[Lori J. Heim, M.D., F.A.A.F.P.]

AAFP President Lori Heim, M.D.

Each year we reach out for your opinions as AAFP members through many surveys and focus groups. We also pay attention to comments that you communicate in other ways, such as via the AAFP e-mail discussion groups and bulletin boards. But we consider the Member Satisfaction Survey to be our annual "report card" because it gives us the big picture -- what you, our members, think about the Academy and what you'd like for us to do going forward. We carefully review the survey results, including the verbatim comments, and incorporate them into our strategic planning activities each year.

This year's survey was in the field at the height of the frenzy over health care reform, and the survey results reflect the frustration and uncertainty you were feeling then. Key survey findings are summarized on the AAFP website(1 page PDF), but I'd like to mention a few of them and how they'll help us going forward.

You're Loyal, but Many of You Are Mad

We were pleased to learn that, once again, the vast majority of you said that AAFP membership was important, that you benefitted from it and that you would recommend it to other family physicians.

However, we also learned that fewer of you were satisfied with the Academy, and fewer thought AAFP leaders were taking the Academy in the right direction, when compared with last year. No leader likes to hear that news, but it's important to know it.

The news also was mixed regarding the AAFP's advocacy priorities. Although more than half of you agreed with those priorities, a third of you indicated ambivalence, and 15 percent actively disagreed with our overall positions. Having only a small majority agree with our priorities is far from a mandate. We know we have work to do to win back some of your hearts and minds.

Much of members' discontent about advocacy can be traced to the Academy's efforts on health care reform. The Congress of Delegates, the Academy's policy-making body, has consistently called for the AAFP to support health care reform, so marching orders for the Board of Directors were clear when health reform finally moved forward this year. Some of you wanted us to insist that payment reform and tort reform be included -- and truly, we would have preferred the same thing. But our assessment was that it was not politically possible given the environment in the U.S. Congress, and that not supporting the reform bill because those elements were missing would have harmed family medicine in the long run.

If you're among those who weren't with us on health reform, we hope you'll agree with our upcoming efforts as we work to get the new law implemented in a way that preserves and protects your interests. We must focus on making it work for family medicine.

Payment Reform is Job No. 1

The survey also made it crystal clear that you want payment reform to be the Academy's top priority in the coming months. You told us that you see value in your Academy membership when you feel the direct impact of our work, such as more money in your pocket.

We've already been working hard on payment reform with some success, but you probably haven't seen much difference in your pocket -- yet. This will change during the next four years, when you should see the 7 percent to 8 percent payment increase called for in CMS' 2010 rules. That increase, plus any money you receive from the stimulus act or for health information technology, came about because of our advocacy. But we all want and need more.

We'll return to Capitol Hill this fall to continue our push for replacement of Medicare's sustainable growth rate formula. We'll also keep hammering at the underlying problem with the current payment system -- that it doesn't recognize the value of cognitive services or pay nearly enough for them. In my opinion, if they're going to value primary care, they need to increase primary care payments by at least 30 percent. Doing that would be a game changer!

By the way, the Academy just launched a new Medicare Action Toolkit that enables you to add your voice and the voice of your patients to the call for payment reform. I hope you'll use the toolkit to help us impose a full-court press on Congress this fall.

CME's Importance Reaffirmed

Survey results also reiterated the importance you place on continuing your education: the AAFP's CME offerings and American Family Physician continued to rate highly in both importance and satisfaction, as did the AAFP's CME recording and reporting service.

In addition, CME moved ahead of advocacy this year when survey respondents were asked to allocate $100 among the Academy's four strategic objectives. Last year, advocacy got the most bucks.

I think this switch occurred because some of you disagreed with the AAFP's advocacy positions -- but most of you look to the Academy for great CME. Rest assured that we'll continue to provide the most innovative, evidence-based CME available, including the CME at our flagship event, the AAFP Scientific Assembly. (It's interesting to note that survey respondents who had attended Assembly were more satisfied with the Academy than those who hadn't attended, and I can see why -- excellent CME, the camaraderie of colleagues and easy ways to learn more about the Academy's activities, all in one place.)

Here are a few other things we'll do as a result of the survey.

  • We'll ramp up our tort reform efforts because you said this should be the Academy's second-highest priority. We know it's a hot topic for many of you, though not nearly as hot as payment, your top priority.
  • We'll strive to make our communications with you more effective, which will help you better understand what we're doing on your behalf. Most of you cited e-mail as your preferred method, so we'll look for ways to improve our e-mail outreach.
  • You gave the AAFP website strong marks for importance and satisfaction. We'll search for ways to highlight the most critical information to make the site even easier to use.
  • You also gave good marks for importance and satisfaction. We'll keep refining the site to make it the best online health information source for your patients. (By the way, the Spanish version( of is getting more visits than ever before -- 6 million since January 2010. Be sure to direct your Spanish-speaking patients to this valuable resource.)

New Avenue Coming for Member Feedback

I hope this column has helped you realize just how important your feedback is and how it guides our activities going forward. In closing, I'd like to announce yet another way the Academy will reach out for your opinions; the new Marketing Research Online Community is a panel of 1,000 of you -- including active members, residents, students and leaders -- who will be recruited to serve as panelists for a year. The AAFP will turn to those panelists for rapid input and feedback on Academy activities and programs.

Responses from this new panel, combined with the input you provide through our surveys, focus groups, e-mail discussion groups, bulletin boards and in other ways, will guarantee that the Academy is even more richly endowed with member feedback in the future.

I hope you're proud to belong to an organization that cares so much about your opinion, and one that is actively trying to solve the problems of health care for you and the American people. Keep talking to us in the months to come. We want to hear what you have to say.