Sunday, August 7, 2011

Family Medicine: Naive Enough to Believe

I just attended the Ohio Academy of Family Physicians (OAFP) Annual Members Assembly in Dublin, OH (Columbus suburb) for many reasons.  Seeing friends who are Family Physicians from all over Ohio, their families and the staff of the OAFP is meaningful and reaffirming.  We know and care about one another.  It works.  Staying connected to Family Medicine and getting updated were other goals for me at the annual celebration.  The effectiveness of the experience is made possible by the outstanding OAFP staff, who are experts in professional organization and support.  Things seem to happen miraculously when they are involved. 

Finding the "Edge" of Family Medicine and its interface with all that is not Family Medicine is another focus for me.  Usually there are "Edge" people at every OAFP meeting who help me to understand how it looks and feels at and beyond the "Edge".  I enjoy hearing about what's happening in every part of the state. 

The "Center" was easy to find at this event (actually several events):  Patients are always at the heart of Family Medicine.  They weren't necessarily invited formally, but their essence and spirit are the hub around which the OAFP is organized.  They are the strength and the weakness of Family Medicine.  Caring for them is what we do and what gives us meaning.  Over and over at this meeting, patients were mentioned and pondered and honored (and cursed?).  We love you, Patients.

Special consideration at the meeting was Practice Transformation.  Big message:  Without PT, Family Medicine will not survive. Family Team Care was introduced as a workable model by Peter Anderson, MD, a solo family Physician in VA who transformed his practice into a PCMH.  The Patient Centered Medical Home (PCMH) was featured last year at this meeting and continues to generate interest and fear.  The state of Ohio is pushing forward with a PCMH project that has promise and clout since Ted Wymslo, MD, who developed legislation to promote the project, is an OAFP member/leader and current Director of the Ohio Department of Health in Columbus.  Ted spoke about the project and the Office of Health Transformation  and change.

The business meeting was notable by its lack of resolutions and lack of controversy.  A Memorial Resolution for Gene Wright, MD OAFP Past President was a special moment.  Jean, his widow, and his children were present to receive a tribute. He was a beloved Leader of OAFP and several aspects of health care in Lima, where he practiced and started a community health center.  He played a critical role in AHEC education for medical students from the Medical College of Ohio and was recognized by OAFP years ago as Educator of the Year.  Gene, though, was a big hearted, fair-minded friend to OAFP leaders and members for decades.  He was loved by his family, his patients and his community, all of which he served with love and compassion.

Collette Willins, MD delivered her President-Elect speech with energy and enthusiasm, followed several hours later by her induction as President and swearing in by AAFP Board member, Reid Blackwelder, MD.  Dr Blackwelder, gave a delightful overview during the business meeting of national issues being addressed by the AAFP.  He aptly noted the dynamic changes in Washington and the various strategies of AAFP to provide continuous input on behalf of Family Medicine.  The SGR and RUC were mentioned along with other reimbursement concerns of family physicians and the AAFP.  Our Academy is working to represent us in a challenging time.  The outcome is uncertain.

The Town Hall Meeting was a very open opportunity for any OAFP member to voice concerns and express opinions about many situations.  Survival issues for the specialty were mentioned in numerous ways, including the workforce pipeline with medical student debt being a threat to students selecting our specialty, increasing employment of FP's by non-physician entities that aren't aligned with patients in the way we would want, reimbursement, regulations and mandates, the economy, etc.  Visiting officers from Illinois and Wisconsin commented on situations in their states and Dr Blackwelder contributed the AAFP perspective.  Many reflected again on the wonders of practicing Family Medicine and the joy of caring for patients, while lamenting the business model that we're trapped in that is mis-aligned with our survival and our patients best interests.

The "Academy Awards Dinner" is always special for me with the passing of the gavel from the out-going President to the new one and the recognition of new officers and (the highlight for me) the recognition of the Fifty Years in Medicine Family Physicians.  Dave Garrety, MD was a special honoree to me in that group this year.

Sarah Sams, MD, outgoing President did a marvelous job during her year as our Leader. A unique surge of Sarah's special energy has lifted the organization through a sea of change, seamlessly.  Her Yellow Brick Road quilt was raffled off (Jeff Susman, MD, Dean of NEOUCOM won it) at the dinner setting a standard that no future President will probably match.  She's come a long way from Pork Queen of Iowa to Quilt Queen and Past President of the OAFP.  Thank you and Way to go, Dr. Sams!

Special moments at the meeting involve the personal relationships formed over the years.  Changes including loss, death, grief, new babies or grandbabies, career advancement, disappointment and satisfaction were all open for hugs, laughs and tears among OAFP friends.  The Family of Family Medicine is alive and well.

In spite of many negative situations that surround us, one could still feel the optimism that something is going to get us through this era.  Family Medicine will survive, was the message.  We don't know how.  We do know why it should survive.  We just believe.  I could feel the belief, but didn't hear how it is going to happen.  It reminded me of a motivational tape I once heard which referred to being naive enough to believe.  It recognized that sometimes knowing too much detail might just get in the way of success.  That may be where we are in this era.  We don't have access to all the information we need to guarantee our survival.  We are "NAIVE ENOUGH TO BELIEVE" that we will.  I think we're right.
What do you think?

More information on the Ohio Academy of Family Physicians Members Assembly from Dr. Mike Sevilla:
Dr Mike Sevilla Post on Ohioafp Meeting Day One

Dr Mike Sevilla Post on Ohioafp Meeting Day Two

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