The Future is Now

by F. David Schneider, M.D., M.S.P.H.

 

Wow is all I can say! My first seven months as TAFP President have been exciting and busy. Since July, I have represented the TAFP at the AAFP National Conference of Residents and Medical Students, the AAFP Congress of Delegates and Annual Scientific Assembly, the TMA Fall and Winter meetings, the AAFP Multistate Conference, the Family Practice Advisory Committee to the Texas Higher Education Coordinating Board, the annual Texas Family Medicine Leadership Conference, and the Statewide Healthcare Coordinating Council’s Conference on Innovative Primary Care Practices. We hosted the Future of Family Medicine in Texas Conference in February and the annual C. Frank Webber CME conference and Interim Business Session in March, and met with Lt. Gov. David Dewhurst to present the TAFP Presidential Award of Merit.

All of these meetings have significance to our future as family physicians — from recruiting new medical students and residency graduates to our state to practice family medicine, to restructuring how family medicine is practiced as a discipline within the house of medicine, to changing the way family physicians are reimbursed for what we do best, managing complex medical illness in the office. We have much work to do if we are to re-establish ourselves at the center of the house of medicine, where we belong.

I have three objectives for my year as president: To make the Future of Family Medicine a reality; to build coalitions within the house of medicine; and to make our voice heard as advocates for our patients. We are accomplishing these in tangible ways.

In early February, family medicine leaders from all around Texas met in Austin to begin the process of rejuvenating our specialty. As all of you are aware, the national Future of Family Medicine project of the Association of Family Medicine Organizations has completed its work. The final report has just been published in the Annals of Family Medicine. But we didn’t want to wait until their publication date to begin the process of change. So on Feb. 6 and 7, approximately 65 family medicine leaders from all kinds of practices and all parts of Texas got together at the Barton Creek Resort to hear the final results of the FFM project and come up with concrete ways to implement the recommendations.

The conference generated numerous ideas for how we can improve the practice of family medicine. The first three the TAFP is working on are: 1) Pursuing a grant from the Agency for Healthcare Research and Quality to develop electronic health records systems for all the family medicine residencies in Texas; 2) organizing a statewide academic health summit to better define the role of family medicine within the medical schools, and 3) developing innovative methods of educating our practicing physicians in new medical practices and techniques.

It is clear that we all need truly integrated electronic health records in our offices, systems that can talk to each other and track data we currently track manually or in our heads. Much of what we spend our time on could easily be automated with today’s technology, so that in the future the mundane won’t even concern us. We should be able to get accurate reports on our patients’ current health status and trends so we can identify signs of disease early. For example, we should be able to know which of our patients have uncontrolled diabetes or hypertension just by typing a few keystrokes, so we can have only those patients come see us for diet counseling.

A significant threat to our survival in primary care is the inadequate reimbursement system. At the state and national levels, our leaders are working to make changes happen now. Dr. James Martin, one of our TAFP Past Presidents, and current AAFP Board Chair, reported that discussions with CMS on the inadequacy of the current reimbursement system for E&M codes could lead to changes that would bring significantly more revenue to our practices. This is crucial for the success of primary care practices — no matter to which primary care specialty we belong.

 
At the TMA, we are working to develop primary care leaders for Texas medicine. We are actively grooming our leadership for leadership positions at TMA, as we have done successfully at the AAFP. We are strengthening the Primary Care Coalition, made up of the leadership of the family physicians, general internists, and general pediatricians. With 15,000 members between the three specialties, we constitute more than a third of the TMA membership. The message we bring to TMA is that quality primary care for our patients can only happen if we are allowed, both logistically and financially, to run healthy practices.
 

The third objective, to be a strong voice of advocacy for our patients continues through our grass roots legislative efforts. Members of our Academy’s leadership sit on many committees and task forces throughout the state in many different organizations. Our message is clear. We must have better, safer health care for our patients.

I look forward to continuing to serve the TAFP for the remainder of my term as president, and beyond as a leader in family medicine. I invite all of you to join me and the rest of our colleagues in the TAFP leadership in forging our future. You either have received or are about to receive communication calling you to join our commissions, committees, task forces and sections. Please consider this call. It is our collective responsibility as family physicians to step forward and make our voices heard.