« The Path to PCMH:... | Main | Sports Medicine One... »

Wednesday Dec 18, 2013

Future of Family Medicine 2.0: What's Your Opinion?

It's time for another update on Family Medicine for America's Health: Future of Family Medicine 2.0. In addition to providing you with details of the latest actions related to this important project, the update below offers family physicians an opportunity to provide input on four specific questions related to payment models, family physician training, research and the triple aim (improving patient care and outcomes and lowering costs).

You can address the questions below -- and offer other thoughts on the project -- at FutureFM@aafp.org.

Family Medicine for America’s Health: Future of Family Medicine 2.0

Organizational Update No. 4

Dec. 17, 2013

This is the fourth update of the Family Medicine for America’s Health: Future of Family Medicine 2.0 initiative. The goal of this effort, which was launched in late August, is to develop a multiyear strategic plan and communications program to address the role of family medicine in the changing health care landscape.

      As a reminder, the Family Medicine Working Party identified a set of key principles that will underpin this effort:

  • Deliver on the triple aim: improving the health of the population; enhancing the patient experience of care (including quality, access, and reliability); and reducing, or at least controlling, the per-capita cost of care.
  • Focus on the needs of residents and medical students, as well as practicing family physicians.
  • Manage the tension between addressing the needs of family medicine as a specialty and needed changes to the health care system of which it is a part.

Strategic Plan

CFAR, the strategic consulting firm hired for this project, is now working on its "current state" analysis. This document is designed to create a shared understanding about where the profession is today. This shared understanding serves as a foundation on which to build an implementable strategic plan that identifies risks to take, investments required to do so, and a realistic understanding of how to bridge the gap between the current state and the desired future we want to create. Following are the key issues that are being examined as part of this process:

  • Core attributes: What are the core attributes of family medicine today, and what do they need to be in the future, for our profession to achieve the triple aim in the service of our patients and the larger health care landscape?
  • Evolving ecosystem: How should family medicine change in response to the challenges of an evolving health care system to best meet the needs of the nation?
  • Education: What changes are needed in the continuum of education (from medical school through residency and into CME) to train the family physicians needed in the new health care system?
  • Communicating value: How do we best communicate to relevant stakeholders the value and benefits of family medicine and the important role family physicians play in meeting the health care needs of the U.S. population?

CFAR has sought broad input from family physicians -- and those who work alongside them -- in the development of the current state analysis. This has included

  • conducting in-depth interviews with thought leaders and stakeholders in the field of family medicine; and
  • conducting a strategic options survey designed to test the assumptions the community holds about the present, as well as perspectives on strategic choices in the future. The survey was sent to more than 6,000 front-line family physicians, as well as a variety of other primary care health professionals, such as OB/Gyns, general internists, nurse practitioners and physician assistants and physicians early in their careers.

     We encourage feedback and would welcome input from family physicians through our dedicated email address FutureFM@aafp.org on the following questions:

  • Can you share any examples of family physicians -- yourself included -- who are working in payment environments other than fee-for-service? How has that experience affected their practice (or your own)?
  • What are some concrete steps family medicine can take to increase the number of family physicians trained to meet the needs of the American public in the future?
  • How can the leadership of family medicine help family physicians meet the demands of the triple aim (improved patient care, improved health of populations, lower cost)?
  • What kinds of research would help improve your practice?

Communications Platform

      APCO Worldwide, the communications consulting firm, is conducting research to develop the communications platform to reflect the strategic plan. APCO has conducted in-depth interviews to elicit attitudes and opinions about family medicine from external audiences including policymakers, major insurers, employees and purchasers and other primary care health professionals. These interviews focused on perceptions of family physicians, the role of family physicians in the new health care era and the future of family medicine. Following is a brief summary of the findings:

  • There is marked appreciation for the skills and patient rapport that family physicians bring to health care.
  • Family physicians are viewed as having a solid diagnostic ability based on their scope of medical and clinical knowledge.
  • Treating the entire family gives family physicians an advantage compared with other primary care physicians in being able to consider social and behavioral dynamics in their diagnosis and treatment.
  • Expertise in prevention and education helps position family physicians for the new health care landscape.
  • Family physicians are seen as the natural choice to lead the patient-centered medical home and accountable care organizations, coordinating care and stressing wellness.
  • There is a strong belief that new comprehensive care models provide family physicians the greatest opportunity to succeed in the new system.
  • Retail clinics are seen as the greatest threat to the family physician.
  • Most cannot imagine a health care system without family physicians.

APCO currently is conducting the quantitative research element of the communications planning process. The results of its broad public opinion survey will be presented in January.

We strongly encourage you to share your input. Again, you can provide feedback at FutureFM@aafp.org. We welcome comments on the items outlined above or other suggestions/insights that would be useful to this process.

Upcoming Meetings

The fifth meeting of the Core Team will be Jan. 9. The next combined meeting of the Working Party, Steering Committee and Core Team will be Jan. 16-18.

Jeff Cain, M.D., is Board Chair of the AAFP.

Comments:

I am currently practicing part time at a Federally Qualified CHC and see mostly indigent patients. I have done this for the last four years. Before doing this I was self employed as a Family Physician in a small town in Michigan. When I started my practice I did everything from OB ,ER ,surgery assist ,hospital and critical care to newborn care. A broard general knowledge as well as an ability to endure under adverse conditions was necessary. Over the years as specialists became more available in the practice of medicine my practice gradually became limited to mostly outpatient office care. The specialists became more critical of FP and actively recruited my patients for their own practices. Often the patients would request specialty care rather than the care I could provide which was often similar, more direct and less expensive. At the FQ clinics I now see PA's and NP's who practice medicine unsupervised and only seek help on complicated or annoying patients.Thus I very much feel the "pinch" to my primary care role from both directions. Maybe the future of family medicine is not more physicians but less physicians practicing FM who are highly skilled in broad areas of medicine AND can manage 3-5 midlevel providers seeing the majority of patients. This would probably require a longer training period with emphasis on internal medicine (both inpt and outpt care) as well as pediatrics and maybe ob/gyn. The bar to get into this type of training program would by neccessity have to be set at a much high level than it is now and be more renumerative to attract top level talent. An effort to merge Internal Medicine, Pediatrics and Family Medicine as one primary care specialty should seriously be considered.

Posted by David M Woodliff MD on January 06, 2014 at 07:19 PM CST #

You must be logged in to post a comment. Login

Want to use this article elsewhere? Get Permissions

Search This Blog


Sign Up


Subscribe to receive e-mail notifications when the blog is updated.

Email address:

Feeds

Disclaimer

The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.