“Strong Medicine for America” elicits strong opinions: Why criticize the AAFP?
Your letters in response to our editorial* about the “Strong Medicine for America” effort by the AAFP brought to light the tie that binds all of us, irrespective of our varying personal perspectives—dedication to providing the best care available
Jeff Susman, MD, Editor-in-Chief
J Fam Pract. 2008;57:148
After reading your editorial in the March issue (“Strong Medicine for America,” J Fam Pract 2008; 57:148), I completely agree with your assertions that family physicians must continue to be the cornerstone of the American health care system, that we must achieve better payment rates, and that we must attract the next generation of family physicians to our residency programs. That’s why I am puzzled that you went on to criticize the American Academy of Family Physicians’ new vigor in championing family medicine’s issues with government, employers, and other private sector payers. Like it or not, these payers make the decisions that most directly impact our future as a specialty. It would be folly to wish for better outcomes without working for it.
The hard truth is that family physicians will face tougher and tougher times unless we convince payers of our value. We cannot assume that doctors will be paid their worth or that medical students will flock to our residency programs unless and until we strengthen our position within the health care system. That’s why the AAFP has embarked on this important campaign—to educate those who question the relevancy of family physicians in tomorrow’s health care system.
“ The hard truth is that family physicians will face tougher and tougher times unless we convince payers of our value”
We have a powerful story to tell—a story about the importance of family medicine as an essential building block for an equitable, functioning health care system—one centered on primary care that produces better health outcomes for patients and better value for payers’ dollars. It’s a story that can influence payment rates, policy, and legislation, as well as health plan design decisions made by America’s largest employers along with federal and state governments. Our effort is designed to do just that, by:
- Communicating the value of family medicine and primary care to ensure that decision-makers strengthen our role as the health system evolves;
- Demanding that Congress enact better payment formulas so we can continue to care for Medicare patients and because the federal payment system often serves as a model for states and private insurers;
- Working tirelessly with private-sector payers to quantify and reinforce the improved quality and lower cost of patient care when primary care, particularly family medicine, forms the foundation of that care;
- Engaging our primary care peers and other health care providers to promote the value of the medical home, where an ongoing partnership among a patient, physician, and practice team provides the basis for comprehensive, coordinated care across specialties.
The AAFP’s outreach will help us achieve exactly what you demand—a health care system that relies on “the resiliency and resourcefulness of the next generation of family physicians.”
But it won’t happen if we don’t speak out for it. That’s what we’re doing: carrying the message to new and important audiences on behalf of family physicians and the specialty we all love.
Jim King, MD, President,
American Academy of Family Physicians
Dr. Susman responds
“ Experienced family physicians are well versed in the art of addressing the worries and expectations of each individual patient”
Thank you for your thoughtful letter. Clearly, discourse on the direction we choose for our discipline is important for our specialty, our patients, and our communities. I stand by my comments, particularly questioning the wisdom of investing in a tag-line, logo revision, and marketing campaign that do little, in my opinion, to clarify the value of family medicine to the public’s health. I know we both are deeply committed to the discipline, and I welcome your candid response. I will continue to call them as I see them—and I trust we can agree to disagree on matters that we hold dearly—but will remain committed to serving our profession, patients, and communities as wisely as possible.
When the new residents start the next academic year, it will be 60 years since the unforgettable photo essay, “Country Doctor,” was published in Life magazine, Sept. 20, 1948. It still evokes the essence of the hardworking “GP” who was called on to care for patients from birth to their last breath. The photographer, W. Eugene Smith, spent weeks with Dr. Ernest Ceriani, who cared for patients in and far beyond the small town of Kremmling, Colo. “Country Doctor” is an enduring portrait of the family physician. This issue presents some of the iconic images from “Country Doctor,” in tribute to family medicine’s legacy.
Linda K. Hengstler, Editorial Director
Dr. Ernest Ceriani, in the hospital emergency room, has just stitched up the head of a 2-year-old girl after she was kicked by a horse
In the kitchen, the doctor telephones a priest, with the information that the patient may not survive the night
Dr. Ceriani, summoned to a rooming house at midnight, wraps a blanket around a critically ill elderly man, as a policeman prepares to take the patient to the hospital
A father holds his infant son as he waits in the doctor’s office for the baby’s check-up
A day at the local rodeo with his wife and young sons would soon be interrupted when a cowboy is injured in a fall from a bronco
