Each year, AAFP holds the National Conference of Constituency Leaders and Annual Chapter Leader Forum together in Kansas City, Missouri. NCCL representatives and ACLF attendees from across the nation gather to discuss various issues, suggest policies and programs to AAFP, and receive leadership training. In 2018, the conferences will be held April 26-28 and TAFP is looking for members to serve on the delegation or apply for scholarships to attend.
TAFP opportunities for NCCL
Spots are available for five TAFP members to represent each of the five constituencies: new physicians (physicians who have been out of residency for seven years or fewer), women, minorities, international medical graduates, and LGBT. TAFP reimburses up to $1,200 for expenses for each delegate. In addition, TAFP offers two other opportunities to attend NCCL with funding. These scholarships will be awarded to one third-year resident and one minority physician.
If you are interested in being considered for one of the delegate slots, please send a current curriculum vitae and/or a statement of intent to Jonathan Nelson at firstname.lastname@example.org by Friday, Feb. 2, 2018. Be sure to let him know which constituency or constituencies you would like to potentially represent.more
By Perdita Henry
In 1988, Jeff Cain, MD, and Glenna Pember, of the Hall of Life and Doctors Ought to Care, had an idea about keeping kids away from tobacco products. They would go on to create Tar Wars, an educational program for fourth- and fifth-grade students. In the 30 years since the first class, Tar Wars has reached more than 10 million children across the globe. The program was eventually bought by AAFP and it became an opportunity for local family physicians, residents, and students to visit classrooms and discuss the health risks associated with smoking, the financial costs of the habit, and the sneaky ways advertisers market their product to young people. In the last few years, the program hasn’t seemed to bring the passion and excitement that it once did. The TAFP Commission on Public Health, Clinical Affairs, and Research wants to see that change.
At a number of commission meetings, members have reminisced about visiting children in their community and teaching them the importance of remaining tobacco free. Visiting schools with the Tar Wars message, by all accounts, seemed to bring joy to students and participating physicians alike. “I loved those mornings at school,” says John Carroll, MD. “I had five classrooms to visit and I spent 35 to 40 minutes with each. We flew through the discovery of being targeted by the second largest public advertising campaign.” After spending time with their local physician, the kids had the opportunity to create their own posters featuring their personal brand of tobacco-free messaging. Those posters were then submitted to state chapters and one would be chosen as the state winner. The Texas winner would receive the prize of hotel and airfare to present at the Tar Wars National Poster competition.more
By Student Dr. Kendra
Step 1, the rite of passage for every medical student. It seems like torture to get to and go through, but it’s the one thing that can affect the trajectory of your whole career in medicine. It’s a daunting task but it seems like everyone — for the most part — has gotten through it pretty well. The journey to it and through it can be ugly, but hopefully, I can offer you some preparation tips that will successfully get you where you want to be. It can seem overwhelming, but focusing on your schedule and the resources available to you can help get past. I will outline my schedule, the resources I choose, and the review techniques that worked best for me.
A few things to note first:more
By Jim Rickards, MD, MBA
Back in 2011, the state of Oregon was facing a massive budget deficit, primarily driven by rising Medicaid costs. Medicaid is government-supported health insurance for economically disadvantaged individuals earning up to 138 percent of the federal poverty level. About 25 percent of Oregon’s population, nearly 1 million individuals, are currently enrolled in Medicaid. This is a similar percentage to what is seen nationally. Not only did the deficit substantially impact the state’s overall budget for health care funding, but the potential impact on the lives of many Oregonians also weighed heavy on the medical community.
Typically, when states try to manage deficits related to Medicaid, they employ a combination of three strategies. For one, they will decrease reimbursement rates to hospitals and providers. This does not work very well because, ultimately, clinics will need to limit the number of Medicaid members they see since they are not financially viable, in turn creating access issues for patients. Second, the number and types of covered services can be restricted by the state. In Oregon, we had already employed the Prioritized List of Health Services for more than 20 years, which served as an evidence-based approach to prioritizing and limiting the availability of health care services. Limiting what was already on the list would not have been possible without denying many essential services. Finally, a state can decrease the number of individuals enrolled in Medicaid. This was not an option either, as Oregon was going to be an expansion state under the Affordable Care Act and would see its Medicaid population grow from 600,000 to a little over 1 million members within just a short time.more
By Travis Bias, DO, MPH, DTM&H
In his commencement address at Kenyon College in 2005, the late author David Foster Wallace told the story of two young fish swimming along. They pass an older fish swimming the other way who greets them: “Morning boys. How’s the water?” As they swim on, one of the younger fish responds to the other: “What the hell is water?”
Feeling and appreciating your body of water takes experience, maturity, and occasionally someone else making you aware of your daily surroundings. It was not until a few years into my career as a family medicine physician that I realized the furious pace at which American physicians learn to swim, insulated in a system that operates in stark contrast to that of other countries around the world.more
Janet Realini, MD, MPH
As is often the case in Texas politics, there was little agreement during the 85th Legislative Session on which steps are necessary to address the state’s many health care challenges. One area that did see agreement, though, was the recognition that far too many mothers in Texas get sick or die during pregnancy or within a year of a pregnancy ending. Unlike the decline of mortality rates internationally, U.S. maternal mortality rates have been increasing, and Texas’ maternal death rate infamously doubled between 2010 and 2012.
Thankfully, the Legislature moved during special session to extend the state’s Maternal Mortality and Morbidity Task Force, which plays an important role in identifying and addressing the core issues contributing to maternal death and severe illness.more
An excerpt from the inaugural speech of the new TAFP President
By Janet Hurley, MD
Greetings friends, colleagues, staff, and family members. It is my honor to stand before you as our next TAFP President. As I watched Dr. Elliott receive this medallion last year, I thought of all of the leaders in the past who have worn this medallion before us. I am honored to receive the responsibility today, acknowledging that this medallion has been around the necks of many giants along the way before me.
My first TAFP meeting was in the summer of 1997, ironically also here in Galveston. I was a student, wandering lost around the conference hotel. I was impressed to feel so welcomed by the TAFP staff and physician leaders, like Dr. David Schneider, who was among my first Academy mentors.more
By Tom Banning
Dave Chase, a friend of mine who was a longtime contributor to Forbes among other magazines, spent the better part of the last three years traveling the country documenting the multitude of failures of our health care system (pricing, contracting, lack of transparency, conflicts of interest), but more importantly identifying simple and tested solutions employers and some local governments have utilized to decrease their total health care spend.
His efforts have culminated in a compelling, must-read book, “The CEO’s Guide to Restoring the American Dream.” We’ve partnered with Dave on several physician–employer community events and in return, he has thoughtfully offered members and friends of TAFP a complimentary digital copy of his book. Below, I’ve provided a link to his TED Talk, “How Health Care Stole the American Dream,” as well as a link you can use to download a copy of “The CEO’s Guide to Restoring the American Dream.”more
What kind of system do we want?
By Tricia Elliott, MD
In his seminal book “The Signal and the Noise,” renowned statistician, Nate Silver, examines the world of prediction, investigating how we can distinguish the truth — the signal— from the noise, which he describes as a universe of ever-increasing information, relatively little of which is useful.
Any candid observer of the now nearly decade-long effort to reform our health care system will readily admit that the health care debate we’ve been engaged in has generated a lot of noise and useless information for political gain. Our elected leaders, on both sides of the aisle, have been busy creating this noise and are now trapped in a political vise of their own making. They’ve sadly left the public with a binary choice of whose health care solution is better, that of the Republicans or the Democrats.more
A model whose time has come
J. Stefan Walker, MD
Luke Fildes’ portrait “the doctor” epitomizes the primary care physician that our younger selves aspired to become.That kind of doctor-owned practice is now slipping away as quickly as the business model supporting it. Where $300,000 per year is the new benchmark for employed primary care positions, the prospect of starting or joining a private practice only to tread water in a sea of acronyms (MACRA, HIPAA, HMO, ACO, etc.) for margins that barely cover overhead no longer makes sense to most family physicians. No wonder that in 2016, for the first time, less than half of American doctors partly or fully own their practices.
As the care of inpatients became a separate field, primary care was mostly sidelined into a 9 to 5 office job in a role now shared with mid-level practitioners, retail clinics, and telemedicine services. Unlike many other specialists still seeing patients during nights and weekends, primary care is now conspicuously absent in that important space, further putting pressure on family physicians to justify the level of reimbursement that can support independent practices. Now a rarity, small primary care practices — even those now thriving — risk succumbing to this tide of obsolescence, not unlike local department stores and indoor shopping malls.more