All of the major family medicine organizations just released their vision for the future of family medicine called Health is Primary: Family Medicine for America’s Health. This report comes on the 10-year anniversary of the Future of Family Medicine Report.
The report lists 7 core strategies:
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Family medicine’s leadership will collaborate with patients, employers, payers, policy makers, and other primary care professionals to show the value and benefits of primary care, as well as the contribution that family physicians make in meeting the health and health care needs of people throughout the United States.
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Family medicine will work to ensure that every person in the United States understands the value of and has the opportunity to have a personal relationship with a trusted family physician or other primary care professional in the context of a medical home.
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Family medicine will, in collaboration with our primary care partners, be accountable for increasing the value of primary care for the patients family physicians serve by putting into effect the following specific measures:
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Lower the total cost of care for the patients family physicians serve
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Continuously improve the health and quality of care of the patients family physicians serve
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Continuously improve each patient’s experience of care as they define it, with an emphasis on access
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Family medicine will collaborate with national stakeholders to reduce health disparities in the United States.
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Family medicine will lead, through ongoing outcomes-based research, the continued evolution of the patient-centered medical home to ensure that it is the best way to deliver comprehensive, patient-centered primary care to patients, families, and the communities family physicians serve.
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Family medicine will work to ensure that the country has the well-trained primary care workforce it needs for the future through expansion and transformation of training from pipeline through practice.
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To give patients the comprehensive and coordinated care and attention they deserve, family medicine commits to moving primary care reimbursement away from fee-for-service and toward comprehensive primary care payment as quickly as possible in coordination with its primary care colleagues.
As you might have guessed, there are parts of this report that I like and parts that I feel miss the mark.The report more boldly calls for physician payment reform and calls more family physicians recapturing comprehensive care of their patients and families.
My two major qualms are 1) that the report still does not explain to the American people who we are, why we’re different, and why we’re the most valuable physicians in the healthcare system, and 2) it blames fee-for-service as the root of all evil. I was asked to write an opinion piece, which appears as an online e-letter where I go into more detail on these points. Here is the link to my statement entitled Health is Primary: Getting Closer, but Not There Yet.
The AAFP’s enthusiasm for abandoning FFS is incomprehensible: those of us who deal with insurers on a daily basis know that it will be far easier to underpay family physicians for the work we do when subject to a multiplicity of poorly designed and evidence free P4P/”value” programs. Like their propagandizing for poorly-designed EMRs, selling of the bureaucratic NCQA PCMH, and campaigning for crippling MU programs, this seems to be another hasty and poorly thought out policy from the AAFP. So far, they are unwilling to discuss the reasons for this decision, leaving many of us to assume that they’re merely doing what the large insurers want them to do.