Guest Editorial

Membership at All-time High for Family Medicine's 'Bold Champion'

June 11, 2014 04:28 pm Rick Kellerman, M.D.

It's time to celebrate! For the seventh consecutive year, the AAFP has set a record for total membership. The Academy now has 115,900 members -- 5,300 more than we had last year and a 24 percent increase over the 93,300 members we had back in 2007.

[Rick Kellerman, M.D.]

Rick Kellerman, M.D.

I remember 2007 well. It was a time of challenge and opportunity for the AAFP. I was AAFP president and then Board chair that year, and the Academy stood at a crossroads.

AAFP total membership growth had been lackluster for a number of years. Members were concerned about the long-term survival of the specialty for reasons that included unfair payment and a declining number of residency positions. The AAFP was advocating on the specialty's behalf, but member research made us realize that we needed to do more, and do it differently.

Happily, we held a new trump card that would make us a more formidable player at the table: We had definitive research showing that the nation couldn't have a health care system that worked unless it was based on primary care. In the United States, that means based on family medicine. We no longer were alone in believing that family medicine made a difference -- the documentation was there in black and white for anyone to see.

It was time to take bold action, and that's exactly what the Board of Directors decided to do. We pledged that the AAFP would speak with a new voice, acting assertively to gain family physicians representation, relief and respect. The Academy would become the "bold champion" members wanted us to be as we ramped up our efforts to position family physicians as foundational to a health care system that works.

The AAFP created a new "brand," complete with redesigned logo and tagline, to visually communicate this change in the Academy's approach. A two-year multifaceted advertising campaign promoted the value of family physicians to large employers, insurance companies, legislators, policymakers and the 2008 presidential election candidates. The AAFP helped facilitate a medical home symposium in Washington that was attended by more than 240 health care thought leaders, and then developed multiple resources to help family physicians transform their practices into patient-centered medical homes.

The Academy also stepped up its communication with members to let them know about the AAFP's new attitude and assertive actions, which continue to this day.

I've been gratified by the way the AAFP has carried out what we promised to do back in 2007. There's no doubt in my mind that the Academy's influence has grown. Congress and the administration now acknowledge that the health care system must have a primary care base. With the AAFP's urging, the federal government has started to find ways to bolster primary care -- witness the Medicare Primary Care Incentive Payment Program, the enhanced Medicaid payment for specific primary care services, the CMS proposal to create a chronic care management code, and the focus on primary care in the CMS Medicare and Medicaid Innovation Center. However, much work still remains to assure an adequate supply of family physicians and adequate payment to keep them in practice.

The AAFP's heightened assertiveness has also helped family medicine residents see the value of Academy membership. The AAFP has made substantial improvement in recent years regarding the percentage of graduating residents who transition to active membership. Among 2012 family medicine residency graduates -- the most recent class measured -- nearly four out of five transitioned into active membership. Many medical associations struggle with this, but the AAFP has made progress.

The AAFP's bold attitude also shows in other decisions the Academy has made in the years since 2007. For example, the Academy has developed a multifaceted approach to boosting student interest, including the decision in 2010 of making student membership free. The result? Today, one in every four medical students, allopathic and osteopathic, is an AAFP member -- 26,900 in all, 10,600 more than in 2007. This early exposure to the specialty could help them decide on family medicine as a career, and even if it doesn't, they're more likely to understand and appreciate the foundational role of the family physician in the evolving health care system.

What will the next bold steps be? The AAFP and other family medicine organizations are working on Family Medicine for America's Health: Future of Family Medicine 2.0. This is the follow-up to the first Future of Family Medicine project conducted more than a decade ago. The goal of this effort is to examine the challenges and opportunities facing family medicine today and define a path forward in the context of a rapidly changing health care landscape. A report on the project will be released this fall in the Annals of Family Medicine.

I salute the Academy's Congress of Delegates, Board of Directors and commissions; the AAFP's constituent chapters; and all AAFP members who have chosen to take bold action on behalf of our specialty and our patients. Let's keep it up until Washington finds the political will to complete the move to a family medicine-based health care system that works.

Rick Kellerman, M.D., an AAFP past president, is chair of the Department of Family and Community Medicine at the University of Kansas School of Medicine-Wichita. He oversees family medicine education for medical students, three family medicine residency programs and postgraduate activities.

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