Friday, June 8, 2012

Instant Review - Get Family Medicine Out of the Shadows

I must say, it has been a while since I was geared up enough to write a post so quickly after an article has been published.  This immediately changed about 10 minutes ago when I read the following article on Huffington Post by Ranit Mishori, MD, MHS in collaboration with a good friend of Family Medicine, Larry Bauer of the Family Medicine Education Consortium.

"Time for Total Family Medicine -- Get Family Medicine Out of the Shadows"

Contained in this piece is a wonderful assortment of problems Family Medicine continues to face as our country's failed system has evolved over time, specifically within the past 20 years.  In fact, this is probably one of the best overall summaries I have seen in quite some time, really taking everything and putting it into one article.  Many of these ideas have been highlighted by a number of our authors and we really do appreciate the time Dr. Mishori and Larry Bauer put into creating this masterpiece.

Similar to a post I wrote back in December 2010 titled "What is Family Medicine," Dr. Mishori describes the frustration Family Docs face when explaining the specialty.  Many people still do not understand why we run from the pediatric floor, to deliver a baby, and then back to the clinic to see our panel of patients ranging from newborns to the elderly.
Me: "I'm a family physician."
Woman: "Oh, you're an internist." 
Me: "No, not really. I am a family doc. I also see children." 
Another woman: "So, you are a pediatrician"? 
Me: "No, I am a family physician. I also deliver babies." 
First Woman: "Ah, so you are an Ob-Gyn!"
Other major points landed in this article deal with NIH funding - 10 cents per $10 of NIH funding goes to family doctor research, much of what is being done in the communities, where >90% of the USA is actually receiving their care and expecting good outcomes.

The author talks about having a seat at the table for valuation of physician services.  As many already know, we have mentioned the RUC (I will say AMA's RUC no matter how much they deny to have an official hand in it - how much do they make on those coding books again?).  As the RUC is currently sub-specialist dominated, I am still convinced that no major changes will be made to go along with COGME's 20th Report - Advancing Primary Care to get the gap in pay for primary care decreased to 70% of sub-specialists.  To be fair, I will say that family doctors do have A seat at the table.  It is interesting how primary care makes up about half the pie of Medicare services but barely has representation at the table valuating said services.

Dr. Mishori also incorporates the "Too Smart for Family Medicine" routine that we so frequently hear about.  Over here, we say that Family Medicine is a waste of your talent.

Much like the initial calling for the Family Medicine Revolution by Jay Lee, MD, Dr. Mishori ends the piece, calling on all of us to rise up to the occasion and change the current culture:
Some of this needed change requires those of us in the field to step up. Maybe we've bought into our own misconstrued image, as the crunchy granola docs, and don't like to rock the boat. Enough. Total docs, let's rock. Let's demand a place at the table of decision makers. It is fine to be the "sensitive" M.D.s -- we believe in that value -- but we need to wise up when it comes to getting our message out.
Let's wise up and get that message out!  Hoping that this can bring some energy to the upcoming AAFP National Conference of Family Medicine Residents and Medical Students in July as well as the AAFP Congress of Delegates this upcoming fall in Philadelphia.