Guest Editorial

Is There a Family Physician in the House (of Delegates)?

April 09, 2015 03:01 pm Jerry Abraham, M.D., M.P.H.

I wasn't expecting to win this election. As I entered the race, I told myself the worst thing that could happen was that I would lose. The road ahead was steep. My opponents were well qualified and experienced -- far more seasoned than I to serve as the resident representative to the board of trustees of the California Medical Association.

[Jerry Abraham, M.D., M.P.H.]

I, on the other hand, was a recent Texas transplant to Los Angeles and a family medicine intern with no experience in organized medicine or politics in California.

What I did know was that I wanted to help shape the future of my profession and the policies that affect physicians and patients. I also knew I needed to be actively involved at the county, state and national levels. I've always had a strong conviction to be involved in organized medicine because if I'm not helping make the decisions that shape my practice, someone else is.

I have always believed it is my responsibility to my patients, and to society, to engage in the debates and discussions affecting patient care, public health, payment reform, medical education and other such issues. That's why I served as a member of the AAFP's delegation to the AMA House of Delegates as a medical student, and I've continued that service as a resident. I've also spent untold hours attending local medical society meetings and advocacy days in my state's capital and our national capital, as well as drafting and reviewing resolutions.

Although I'm still not exactly sure how it happened, the residents and fellows of California did elect me to serve on the state medical association's board. I am honored to have the responsibility and thankful that they entrusted me to uphold the virtues, values and interests of our profession. We share a vision for putting patients and primary care at the heart of health care.

Still, I can't help but wonder why I see so few of my primary care colleagues getting involved in leadership. Of course, I've heard plenty of reasons: it's too political; it's too expensive; it's too time-consuming; there's too much tension between the different specialties; and on and on. But I challenge you to consider what is at stake. We can't sit on the sidelines as our future is molded by others.

For example, physicians have now been slapped with a 21 percent Medicare payment cut that only Congress can remedy -- hopefully, by permanently repealing the sustainable growth rate. But even if that can be accomplished, primary care faces numerous other challenges.

As family physicians, we know the solutions that are needed to fix our broken health care system. We know that our country needs more primary care physicians, more family medicine residency programs and more medical schools dedicated to producing America's future personal physicians. We know that family physicians are often on the frontlines of the many crises facing our patients. Knowing all this, we can't afford to sit back and let someone else decide matters for us. We need to be at the negotiating table.

Given family physicians' burgeoning patient volumes and long work hours, it may seem impossible to get involved. Even more frustrating can be the harsh reality that because of their schedules, flexibility and lifestyle, other specialists may find it easier to participate in organized medicine. But I assure you that if you have the desire, there is a way to answer the call to serve.

Still, it's important to realize that participation does not come without sacrifice. I couldn't do what I do without the support and encouragement of my resident colleagues, residency faculty and administrative staff. This has included accommodating schedule changes, taking extra call, and making provisions for time away for advocacy. Most of all, it has required us all to be creative and committed to making it work.

I hope that everyone who is passionate about family medicine considers taking up the challenge of getting involved. During the coming months, in fact, the AAFP will provide numerous opportunities to participate in Academy leadership:

  • April 30-May 2, in Kansas City, Mo., the National Conference of Constituency Leaders will meet to elect new leaders and develop policy on behalf of the Academy's five constituency groups: women; minorities; new physicians; international medical graduates; and physicians interested in gay, lesbian, bisexual and transgender issues.
  • May 12-13, in Washington, D.C., family physicians can learn about advocacy and apply those skills on Capitol Hill during the Family Medicine Congressional Conference.
  • July 30-Aug. 1 in Kansas City, Mo., several leadership positions for students and residents will be determined during the National Conference of Family Medicine Residents and Medical Students.

But you don't have to be a student, resident or member of a certain constituency to get involved. And you don't necessarily have to leave your home state to make a difference. Get involved in your state chapter. Join your local medical society, go to your state medical association annual meeting, or throw your name in the hat for an election.

As family physicians, we must be at the negotiating table. We must stand together and work with our subspecialty colleagues to shape a better health care system, one that works for both patients and physicians. We can no longer afford to sit on the sidelines. Now, more than ever, our patients and our specialty need us to take an active role.

Jerry Abraham, M.D., M.P.H., is a family medicine resident at the University of Southern California Family Medicine Residency Program in Los Angeles. He serves on the California Medical Association Board of Trustees, the Los Angeles County Medical Association Board of Directors, and the American College of Medical Quality Board of Trustees. He is also an AAFP delegate to the AMA Resident and Fellow Section and a delegate to the Committee of Interns and Residents.