Family Medicine On The Move

Last night I spoke with the president-elect of the AAFP, Ted Epperly.  This is the guy who will shortly be running the show (as much as one person runs any national organization) at a time of dramatic change in American Medicine.

Epperly probably expends more energy in a day than I do in a week, so he’s perfect for his new job.  He mentioned that he is currently traveling close to 260 days a year.  Just the thought of being on the road that much makes me develop a nervous tic.  I often wish I could travel more…but not that much more.  I’d forget my own address.

Most of what I discussed with Epperly was with regard to running for an elected position at the AAFP.  There are numerous spots that need to be filled by family medicine residents and students every year; many of the elected spots go to attendees at the National Conference, where I’ve been for the past 5 days.  Epperly suggested that if anyone wants to lend a hand at the AAFP – student or resident – there will be a place for them.  The spot I was considering – as a delegate to the AAFP – would have required quite a bit of national travel and I needed my program director to support all the time away.  Turns out I didn’t apply for the spot and there appears to have been a good group of applicants this year to choose from anyway.  So, nothing lost by me not applying.

That said, according to Epperly anyway, I’m certainly not off the hook.  Nobody involved in family medicine is, irrespective of their involvement in the AAFP.  His premise is that American Health Care is poised for enormous changes over the next few years.  Both Obama and McCain will confront a care system that, for various complicated reason, is in shambles.  Idealogues both conservative and liberal (they like the term “progressive”) clearly see that reform of our system is imminent.  Exactly how that change occurrs, and who gets the lionshare of the “spoils” is going to be determined by how well each interested party lobbies the decision makers.  Thus, every believer in family medicine needs to be a part of the communication process.  Involvement in the AAFP is one way.  Letters to lawmakers is another.  Lobbying the AMA, letters to editors and blogging are big too (think, Kevin, M.D. etc.)

Without hesitation I say that family medicine doctors should be a major part of a health care system restructuring.  I think that family medicine – broadly-trained, general physicians – are without doubt the most effective and efficient agents in delivering health care.  I think they should have more power at the health care bargaining table than business, pharma, legal, governmental, insurance, para-professional groups, and allied health organizations that promote doctor-nurses, nurse practitioners, physician assistants, etc.

I’ve lived overseas and utilized a national health care system (Israel).  Additionally, I’ve read about the nationalized systems in New Zeland, Australia, UK, Canada, France, Germany and Japan.  While they all have their problems, one thing they have in common is an emphasis on primary care, and usually that care is provided by generalist doctors who have been trained in medical school and residency.  A recent article in the New York Times about eye-widening success in reforming health care in Siberia also describes how money was allocated almost exclusively toward primary care in individual villages.

Epperly was inspiring even because he is so confident that family medicine will prevail in this tussle for health care money.  His belief appears to be grounded in the idea that ultimately, family medicine is the best medicine not only for individuals, but also for health care systems.  Really, the only thing that appears to concern him is whether or not that message will be articulated effectively.  Epperly and some surrogates will be attending the Democratic National Convention this fall, and some other AAFP heavies will be similarly attending the Republican Convention.  The guy is on the road nearly every day in an effort to get the message out.  All who believe as he does, and as I do – that family medicine is the superior method of health care delivery – need to follow Epperly’s lead.  We may not travel the country 260 days a year, but we need to tell our stories that often.  If the world knows, healthcare wins.

4 thoughts on “Family Medicine On The Move

  1. Good luck. It seems all of medicine is dominated by folks who know nothing of sick people. As a friend of mine lamented when he got into administration, “I thought we were going to talk about germs. All we talk about is money.”

    When second rate administrators make 400 grand a year, and family docs can barely scrape by and make payroll, and when the whole system is political rather than medical, then it is almost impossible to deliver decent care.

    For years and years we watched the evolution unfold. I wrote and called every politician we elected. None had a clue and the system wound up in an unmanangable state. I retired from all efforts to try to change it. It was only a frustration, and not worth the time and effort.

    I do my job every day because that is who I am and what I do. When my generation is gone, the suit and tie crowd will have their due. One fine day administrators and politicians will not have guys like us. They will blame each other and argure about which forms to fill out, but not know a myocardial infarction from passing gas. They will have the medical care they deserve.

    Dr. Tom Bibey


  2. secretwave101

    Dr. Tom – I feel your pain about having done your part and watched the medical system crumble around you anyway. The tired phrase about how evil prevails when the good do nothing doesn’t seem to have applied to medicine. That said, perhaps your work served to bring up another generation with similar convictions, ready to carry the message and fight the fight until health care is accessible, fair, rational and adequate.

    People like Epperly believe that success is near. If true, perhaps it was your work that got us to this point.


  3. me

    I wish you luck…

    Too many Fox Spews-watching ditto-heads cry that any reform of the US’s current, broken-beyond-fixing health care system is a communist plot that will prevent them from getting whenever they want, damn the cost and/or medical necessity.

    How about a nice slice of tort reform with a side of common sense, topped with care for all Americans, hold the insurance company administrivia, denials, lack of transparency and other BS?


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