An excerpt from the 2013 incoming presidential address
By Clare Hawkins, M.D., M.Sc.
TAFP President, 2013-2014
Change is inevitable. We can change or die. As family physicians, we can lead the coming change in our health care delivery system.
Charles Darwin said, “It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.”
All of U.S. health care is going through profound and uncharted changes as we travel through health care reform. AAFP and TAFP have been working with family physicians for a decade leading the way to a system of primary care which maximizes the efficiency and effectiveness with which we can serve our patients to remain healthy or get well. This has included the Future of Family Medicine project, TransforMED, and the patient-centered medical home movement.
Most recently it has involved advocacy with government and private industry to recognize and reward the value we provide to the health system. Our state and national academies continue to work with our members to better understand how to evaluate the strengths of independent practice or joining a large group. The Academy continues producing programs to understand accountable care organizations and integrated clinical networks.
Instead of lecturing you on health care reform, I’d rather give you a snapshot of how I parachuted into this moment of change. In June 2012 I became a U.S. citizen and am proud of my adoptive state. As many have said before me, I wasn’t born in Texas but I got here as fast as I could. It has been a privilege to live and work in such a welcoming state.
My biggest recent change is that the residency program with which I have been director for 15 years, Legacy Community Health, is now a federally qualified health center. This allows us to provide a greater range of services for our underfunded patients, but has posed a lot of transitional challenges for our faculty and residents.
As American journalist and writer Gail Sheehy said, “If we don’t change, we don’t grow. If we don’t grow, we aren’t really living.”
What is clear about health care reform is that how we will all move forward from here is unclear. Will the health insurance exchanges work? Will the federal mandate for insurance hold? Will the number of uninsured shrink? Will Medicaid ever expand in Texas? With so much unclear, we need a strong TAFP now more than ever, to help us not only react to the change, but to lead the change.
TAFP’s advocacy efforts were central to regaining such important ground in the 83rd Legislature. Through the advanced strategy of our CEO Tom Banning and our strong physician leadership, your Academy drafted legislation well in advance of the session, putting us in an excellent position to make our case to legislators. In an ever-changing landscape, we succeeded in mending the women’s health care safety net; we achieved the partial restoration of graduate medical education funding for family medicine residencies; we secured funding for new residency positions; and we helped convince the Legislature to recommit to the promise of the Physician Education Loan Repayment Program.
One year is not enough time to accomplish all the things I hope to do for our Academy, but with the help of our excellent physician leadership and our capable and talented staff, I am confident we will have a fantastic year. As president, I’m aware that the Academy staff is the steady feature which preserves continuity. I have been a member of the Executive Committee for nine years and am consistently impressed with the caliber of our staff.
Even as our chapter changes and grows, we maintain a strong ethic of member service and are frequently polling our leaders and members to try to improve. Our board structure has just gone through a metamorphosis that will increase our efficiency and effectiveness, and within the next couple of years, we will change our major meeting schedule to make them better and more accessible to our members.
To help manage political change outside of TAFP, at the state and local level, we are fortunate to have a nimble and adroit political advocacy team. Even though this is not a year when the Texas Legislature will be in session, the interim provides an opportunity to lay the advocacy groundwork for the session in 2015. We will seek to expand our state’s primary care workforce and preserve the scope of family medicine. We will advocate for the full restoration of GME funding, including renewed state investment in family medicine preceptorships. And we will work to preserve the sanctity of the patient-physician relationship by arguing against laws which would prevent our ability to discuss gun safety, family planning, and other important public health issues.
Another area of constant change for our Academy is one of our core missions, the provision of continuing medical education. For the last 15 years, I’ve been part of the team that plans educational programming for the Academy, and I have been continually impressed with the work of our Academy’s director of professional development, Jessica Miley, to deliver high-quality programming with the help of the TAFP Commission on Continuing Professional Development. Together with the AAFP Commission on Continuing Professional Development, we want to streamline educational opportunities for our members and help them maintain board certification and state licensure. In this, we will continue to change and improve.
And for our patients, it is my hope that as TAFP serves family physicians in Texas, there will be a direct benefit to the families of this great state. The changing face of Texas needs family medicine. After all, we are the only specialty that is defined by our ecology. We are not defined by a body part, by a disease, or by a gender. We care for all, for whoever comes to see us regardless of what is wrong with them. We advocate for health care for all, and we do all that we can to heal our patients. When our patients cannot get better, as often happens, we remain with them and their families. As the old medical adage goes, “To cure sometimes, to relieve often, to comfort always.”
God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. I would like to ask for your assistance in working with me to make our Academy ever stronger and to help make our state a better place to live.
Clare Hawkins, M.D., M.Sc., is the program director of the Houston Methodist Family Medicine Residency Program at Legacy San Jacinto in Baytown, Texas. He is board-certified in family medicine and board-certified in palliative care, and holds a master’s degree in Community Health Science.
After receiving his medical degree from the University of Manitoba, Dr. Hawkins completed residency at St. Boniface Hospital in Winnipeg, Canada, in 1986. He became a faculty member at St. Boniface shortly after residency and became program director there in 1995. In 1998 he relocated to Baytown to join the San Jacinto program. His special medical interests are palliative care, COPD, asthma, obstetrics, pediatrics, and outpatient surgical procedures.