President's Letter

The resilient nature of family physicians

By Javier “Jake” Margo Jr., MD
TAFP President

Greetings colleagues! Even though it is pretty much a cliché at this point, I just have to say: Wow, what a crazy year. As the summer has both flown by and simultaneously seemed to last an eternity, I have found myself thinking a lot about resilience. Even in the constant tumult of 2020, our members across the state and all over the country have adapted, learned new technologies, and implemented new processes to try to keep their clinics open for their patients.

Certainly for some, that proved impossible, and it may be months before we know the true damage done to our primary care infrastructure by COVID-19. Yet we know so many family physicians are finding ways to make it through and to continue to take care of their communities. We have circled the wagons and battened down the proverbial hatches. We are cautiously exploring what actions and activities are safe in our schools and our communities. We are moving forward with hope and optimism.

Amid all this upheaval, one thing I’ve realized is that I am enjoying having more time to spend with my family while spending less time out on the road. We’ve taken more walks together and had more time to talk. I hope that is true for all of you as well.

In July I had the pleasure of attending — virtually, of course — the Wilderness Medical Society’s summer conference. One of the association’s founders, Paul Auerbach, MD, of Stanford University School of Medicine gave the keynote address, and in the spirit of resilience, I want to share three bits of wisdom I took away from his presentation.

  1. Be kind to yourself.
  2. We should measure happiness in hugs, handshakes, and smiles.
  3. Show yourself some compassion.

We all need more of this in our lives, so please find some time to focus on your health and well-being. Seek out the joy in everyday life. Go for a walk at sunrise or sunset. Listen to the birds and watch the rabbits play. We often get so locked into the next thing, the next task, the next chart to complete, the next bill to pay that we forget to take a moment and enjoy just being alive.

On another note, we have some exciting events and projects on the horizon at the Academy. As you know, the 87th Texas Legislature will convene in January. In preparation, TAFP commissioned a report from FTI Consulting, an independent global business advisory firm, to study the impact the COVID-19 pandemic has had on Texas’ health care system. We recently published the report, and you can read it in this issue of Texas Family Physician.

The report, “The Primary Care Marshall Plan: A Five-Point Plan to Transform Health Care in Texas,” lays out specific actions that policymakers should take to reimagine and transform how primary care is funded and delivered to improve the health and economic productivity of Texans, reduce overall health care spending, and prepare us for future public health emergencies. Early this year, Speaker of the House of Representatives Dennis Bonnen appointed a select committee to study health care costs during the legislative interim. The recommendations in this new report should inform the work of the interim select committee. The five-point plan recommends the state should:

  • Lead the way for primary care payment reform by changing the existing transactional RVU-based, fee-for-service model to a prospective payment model that supports continuous, comprehensive and coordinated care;
  • Decrease the rate of uninsured Texans through innovative market-based solutions;
  • Enable physicians and other health care providers to continue adapting to the digital age by supporting regulatory and payment changes that ensure appropriate use of telemedicine;
  • Ensure that all Texans have access to primary care by aligning state appropriations with Texans’ current and future health care needs; and
  • Develop effective public health workforce and surveillance capacity through a new kind of community health worker and full integration and interoperability of health care data across all levels of government.

There’s no question that this pandemic has shown us in stark relief the fissures and cracks in our broken health care system. It has also crystalized our need to transform the way we pay for and deliver care. For months we have written about the need for a Marshall Plan for our primary care and public health infrastructure. COVID-19 has given us a roadmap to repair and rebuild a stronger, more resilient system so we can be prepared for future health crises. We believe our elected leaders have an unprecedented opportunity to redesign our health care system so it truly serves Texans and the professionals who care for them, and we hope this report will help guide them.

Finally, as I’m sure you’ve heard, we’re taking this year’s Annual Session and Primary Care Summit virtual. We’ll be offering up to 13.75 CME credits for your streaming enjoyment on November 6 and 7. Our Annual Business Meeting and Member Assembly will take place on October 24 at 9 a.m. Central Time on Zoom. All members are welcome and you can register for that on TAFP’s website as well.

I hope to see you online!

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