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Friday May 19, 2017

Spread the Word: Family Medicine Is the Solution

On May 23, hundreds of family physicians will be on Capitol Hill to talk with legislators and congressional staff about issues that are important to family medicine. Of course, not everyone can make it to the annual Family Medicine Advocacy Summit, but you can still help spread the word about our specialty by participating in a National Day of Action the Academy will be promoting on that same day.

The goal is to reach at least 1 million people on social media and let them know that family physicians can help them not only get healthy, but stay healthy. Please join the National Day of Action effort to share our #StayWellSoon message. In the process, I hope we can give the public an understanding -- and appreciation -- of what it means to be a family physician.

It's important for patients, payers and policymakers to know that we care for everyone -- regardless of age and gender -- and we treat the whole patient, not just a disease or a single organ system. Family medicine is about counseling, prevention, diagnosis and the treatment of chronic conditions. We're not just here for coughs and colds.

I shared a related story with Zubin Damania, M.D., of Las Vegas, (perhaps better known as ZDogg, M.D.) last week during his Facebook Live show.  I recently had a patient come see me for -- you guessed it -- a sore throat. But I didn't just treat his symptoms. We had a conversation that led to a discussion about snoring and sleep apnea, and it turned out that this patient was falling asleep while driving.

The point is that we listen to our patients, we care about their health goals, and the relationships we build with them over time allow us to see the big picture. Damania -- who has more than 600,000 social media followers -- was trained in internal medicine and is employed by a hospital, but he gets it and has become an unlikely champion of our specialty

"It's so important that we realize the American health care system is so backward," he said during the May 10 live show, which was watched by more than 13,000 people and will be posted again on his Facebook page  May 21. "We have so many specialists, and not as many family physicians and primary care (physicians). When you look at how we spend and how we manage sick care instead of health care, everything is backward. But we have an answer to fix it, and it's right in front of our face. It's family medicine."

We also discussed the fact that primary care and prevention represent less than 10 percent of U.S. health care spending, and increasing the investment in primary care could save millions. When you watch the video, you might notice that we didn't specify whether we meant millions of dollars or millions of lives. The answer is likely both.

Everyone, Damania said, needs a family physician to prevent illness and to stop illnesses from progressing to more serious conditions.

"Half the patients in the hospital didn't need to be there," he said. "It's not just an economic disaster, which it is; it's a moral and ethical human disaster. These people are suffering."

The answer, he said, is to transform our sick care model to a true health care system with primary care at its foundation.

Spread the word, and #StayWellSoon.

Wanda Filer, M.D., M.B.A., is Board Chair of the AAFP.


Family medicine is the solution, but it must first solve the most important problem facing family physicians. We cannot be as promoted until we solve the revenue too low, costs of delivery too high, and complexity increasing in multiple dimensions. Promotions for happiness or wellness or mental health improvement are hollow words given the situations that we face.

Happy Family Doctors Day contained information for patients with depression, but not for family physicians facing loss of control, loss of support, and loss of meaning.

It is a time of reflection for family medicine as we face these losses at all levels local, state, and national as well as across practices, programs, departments, and associations.

Loss of control, loss of support, and loss of meaning are the constructs used by Dr. Eric Levi as he brings the words of a recent widow to light. She outlines the path that led to her husband’s tragic suicide in the Dark Side of Doctoring. https://ericlevi.com/2017/05/13/the-dark-side-of-doctoring/

Once you have reviewed this blog or shared this with family or others, many areas come into sharper focus. The designs must be changed.

Truly Happy Doctors Days require a focus on those that give care and the designs that fail them as support is decreased, control losses multiply, and meaning is lost.

Where we work, we are surrounded by signs that promise 24/7/365 support for us – in the area of Electronic Health Records. How many critical incidents must traumatize us before those who deliver care seek help or help finds us?

Morale is declining and burnout is increasing. Our employers are asking us to do more for less. And AAFP is asking us to do more for them at cost to us. The various innovations and “reforms” do much the same resulting in more required with less support, especially where family physicians are most important where few others remain delivering needed care.

We need more revenue, decreased costs of delivery, and less complexity – the opposite of the Perfect Storm. We need an association that will break help us break through this Perfect Storm. Indeed this is the only solution for members of AAFP, AAFP, more entering and remaining in family medicine, and movement to higher primary care functions.

Spread the Word, Health is Primary, other promotions, and every major AAFP function must focus on changing the financial design so that Happy Family Doctors Day is every day that we practice. It is why we chose family medicine. It is why we once had over 85% of FM graduates stay for a lifetime of family practice. The designs have sent this plummeting to less than 70% as family physicians scramble to find better designs that fit finances, family, and function.

Posted by Robert C. Bowman, M.D. on May 20, 2017 at 12:48 PM CDT #

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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.