Challenges and Goals for the New Year

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

As my time as president of TAFP moves on, I am amazed at how often our Academy is called on for help and support. Everyone wants their family docs involved! The American and Texas Academies are inundated with daily requests to participate in or endorse various programs, policies or coalitions. The opportunities run the gamut from debating policy changes within the Medicaid program and participating in tort reform coalitions, to endorsing certain requirements for maintaining our professional license. The list seems endless. That we are asked to help in so many projects for our communities is a testament to the trust our patients and the public at large have in us. It is our responsibility and great opportunity to marshal our forces, allocate our resources and spend our time and energy in the most effective and efficient manner possible.

Getting Our Arms Around Obesity

In addition to serving as TAFP President, I also serve on the AAFP’s Commission on Public Health. One project that the American Academy has enthusiastically embraced and will be rolling out in the near future is our new fitness initiative, Americans in Motion. Our current AAFP President, Michael Fleming, M.D., is the self-identified “AIM poster child.” In his inaugural address at the AAFP Congress of Delegates this past October, he promised that we would see a lot less of him by next year’s meeting. I understand he has already lost 19 pounds!

Through this project, the Academy has taken a broader view of fitness. Not only do we refer to physical fitness, but emotional fitness as well. We are developing a tool kit to help family physicians get in shape and to help us teach our patients about the importance of fitness and to assist them in achieving that goal. This multifaceted project will have both direct clinical and community education components. The clinical components being developed are a tool kit to use in your office. The community education part will be modeled after the Academy’s successful Tar Wars program.

As highlighted in this issue’s cover story, TAFP member Eduardo Sanchez, M.D., our Texas Commissioner of Health, has made this issue his top priority. This is extremely appropriate given the statistics in Texas. I live in one of America’s fattest cities — San Antonio. If we’re going to reverse this trend, we all need to do our part.

I hope you will join with me and your colleagues around the country and participate in the AIM program. You will be receiving numerous mailings and CME-related opportunities to participate in this battle. If we are going to be successful in fighting America’s No. 1 public health issue, we will ALL have to “walk the talk” in fighting obesity.

Showing Students the Way

Another opportunity we have is the ability to help shape medical students’ thoughts about family medicine and the practice of medicine in general through our clerkship and preceptorship programs. Family medicine is the only specialty that consistently uses our community physicians to help teach our medical students. This means that in family medicine, our students see and participate in “real-world” practices, but they hear all of our “real-world” gripes, as well.

Despite the need for more family physicians, our residency programs are having a difficult time recruiting U.S. medical graduates. Why, you ask? Some of the reasons are obvious. The average medical student graduates with over $100,000 in debt and they know that primary care physicians are among the lowest paid physicians in the United States today. They also know that we work hard. But it also may be that those “real-world” gripes impact their decisions about which specialty to pursue.

While you and I know that the burden of regulation affects all physician practices, the medical school environment is somewhat sheltered from this. When you have a student working with you, please emphasize the aspects of our specialty that we all love. For most of us, it is the relationships we develop with our patients. And for our patients, research shows that it is those relationships that they value most.

If you are not happy in family medicine, then please don’t accept students into your practice. You are hurting both our specialty and the entire profession of medicine. What we teach in the family physician’s office is communication and professionalism, along with the evidence-based practice of family medicine. Let’s keep it that way.

FUTURE OF FAMILY MEDICINE IN TEXAS

In February the Academy will convene the Future of Family Medicine in Texas Conference. Our hope is to come out of that conference with tangible ways of changing how we family physicians practice family medicine. We will take the AAFP Future of Family Medicine data and recommendations and work through them to decide how we can implement the changes we know need to happen to keep family medicine in the center of our profession. The invitations have gone out and the results of this conference will be reported to you in the next issue of TFP.