By Kaparaboyna Ashok Kumar, M.D., F.R.C.S.
TAFP President, 2009-2010
Last fall as I watched Roland Goertz, M.D., carry out his successful campaign to become AAFP’s new president-elect aided by our physician leadership and supported by our members, I was struck by something he frequently told audiences. In the midst of the concern and confusion surrounding the health care reform debate taking place on Capitol Hill, Dr. Goertz would look out at the crowd with hope and congratulate everyone for having the chance to live in interesting times. What a great perspective.
We have every reason to be optimistic about the future of family medicine. Demand for the comprehensive, attentive care we offer our patients remains strong and the recognition among policymakers of our value in the health care system has never been greater. At the state level, TAFP has become a trusted and respected resource for lawmakers as they craft legislation, and at the national level, senators and congressional representatives seek the wisdom of family physicians in their deliberations. These are indeed heady days for our organization and our specialty.
Even so, a distressing problem plagues us still. There are not enough of us, and too few of the best and brightest medical students choose to pursue careers in family medicine. Amid the din of political wrangling in Washington, D.C. over contentious reform proposals, this problem rings loudly and cannot be ignored. America’s primary care workforce is not sufficient to provide the high-quality, well-coordinated care any reform requires to succeed.
When Massachusetts—the state that boasts the highest ratio of primary care physicians to population—implemented universal coverage by mandating that all citizens earning more than $32,508 must obtain health insurance, average scheduling delays for primary care office visits doubled. People are waiting two months to see a general internist, according to an article in Medical Economics.
As I announced in my inaugural speech in Arlington, this is and will continue to be the focus of my efforts as TAFP president. In fact, it’s not a new course we’re charting. The Academy has been addressing this problem in many venues for years. The successful campaign to substantially increase the state’s investment in the Physician Loan Repayment Program is among the most exciting developments in the last several legislative sessions for the future of our primary care workforce.
But if you consider that the program could place up to 225 new family physicians in underserved areas next year, then you consider that in 2009, Texas medical schools graduated 96 students who entered family medicine residencies and only 73 of those chose to stay in Texas for their graduate medical education, well, you see the problem. We must do everything in our power to encourage students to consider family medicine in a new light. We have to dispel the myths about the specialty: that you can’t make a decent living, that you can’t have a balanced and fulfilling lifestyle, and that the practice of a family physician is monotonous and unchallenging.
Of course we must also pursue policy reforms that would change the way we pay for primary care so that family physicians are paid appropriately for the work we do and the cost-efficient care we provide, and we must continue to call for administrative simplification in our transactions with payers, both private and public. TAFP and AAFP are committed to fighting for these changes, but individually we can each make a difference in our communities by sharing the joy and satisfaction we find in practicing the art of family medicine.
In the past few months, I’ve had the privilege of doing just that by visiting Family Medicine Interest Groups at some of our medical schools. I’ve been joined by TAFP CEO/EVP Tom Banning on these ambassadorial sojourns, and Melissa Gerdes, M.D., I. L. Balkcom, IV, M.D., and Troy Fiesinger, M.D., have made visits as well. We’ve also made presentations at several of our family medicine residency programs, and we intend to make as many of these trips as we can in the coming months.
The response has been tremendous. The enthusiasm we see in the faces of these students is inspiring. Not only are they interested in the health care reform debate occurring in Washington, D.C., and the legislative interplay in our own statehouse, but they exude a desire to care for the whole person rather than just an organ or a system. And many are excited about the prospect of having their loans paid through the new Physician Loan Repayment Program.
We’re drawing good crowds and while we know we can’t change them all or convince them all to join us, reaching those we can is critically important. The students are full of questions and I think they’re surprised by much of what we have to say.
At our next conference, the C. Frank Webber Lectureship and Interim Session in Austin, March 4-6, we plan to convene a group of family medicine department chairs and educators to discuss strategies to generate more interest in family medicine and to secure the foundation of our specialty for the future. It should be an engaging convocation and I’m eager to hear what our colleagues will bring to the conversation.
I urge you to participate in support of this cause in your own community. Find opportunities to serve as an ambassador for family medicine. Talk to your patients, your social organizations, and your business associates. Consider being a preceptor for medical students. Come to C. Frank Webber and Interim Session or a local TAFP chapter meeting and explore the possibility of taking on a leadership role.
Family medicine is in the news and it pervades the national discourse. Now is the time to share what a wonderful specialty it is. Who better to do the job than us?