From the USA - speech of new AAFP president Jeffrey Cain MD

November, 2012

AAFP Flying to New Heights Says New AAFP President

Article and photograph by Matt Brown, reproduced courtesy of AAFP News Now. For more news from the American Academy of Family Physicians and their recent annual assembly go to AAFP News Now

Family physicians are right in the middle of a paradigm shift that currently is shaking the foundations of health care delivery, poised to pilot a strained system to a brighter, healthier future.

New AAFP President Jeff Cain, MD, (right) celebrates as he accepts leadership of the Academy from new Board Chair Glen Stream, MD MBI

That was the message from newly-installed AAFP President Jeffrey Cain, MD, of Denver, to his family physician colleagues here on October 17 at the Opening Ceremony of the 2012 AAFP Scientific Assembly.
"Today, family physicians stand … ready to move from (being) the lone eagles of medicine to valued and rewarded leaders of a health care system … that can deliver higher-quality medicine at a lower cost and - most important to us - healthier patients," said Cain. "To take this flight, we need … the belief that this is possible, … a moral compass to do what is right for our patients, and … to shift the conversation about health care to family medicine creating stronger doctor-patient relationships (and) bringing economic accountability to our health care system. In short, we need to recognize that family medicine really is the future."

Cain said that health care delivery in the United States has evolved out of the turbulent managed care decade of the 90s, with doctors, patients and payers coming to understand that primary care is indispensable to health care delivery, but also that a health care system built primarily on controlling costs via decreased access does not fly.

"Twenty years later, this century has brought great news for family medicine," Cain said. "The Keystone III conference, the Future of Family Medicine project, the work of (Barbara) Starfield and (Paul) Grundy - each has given a resounding endorsement to the efficacy of family medicine, to the now proven fact that there are both health benefits and economic value in the personal relationship between family physicians and their patients. We now have proven that having a primary care physician provides higher quality care, lower costs and healthier patients." But, Cain cautioned, family physicians also are stuck in a holding pattern of sorts - a transitional time full of challenges as well as promise. He said the challenges of practicing in the current, dysfunctional health care system include:

  • spending 18 percent of gross domestic product on health care,
  • paying for 50 million uninsured patients,
  • living with low fee-for-service payments,
  • losing bright medical students to other specialties, and
  • the politicizing of health care in general.

On the other hand, Cain said, there is now an understanding that effective primary care bends the cost curve. States such as North Carolina are saving significant Medicaid dollars, and some payers are starting to pay FPs in new and better ways. In areas like Grand Junction, Colorado, family physicians are creating successful systems that improve the community's overall health and economic outlook. "Family physicians have created medical communities that reflect family medicine values - yours and mine," he said. "That means strong family physician leadership, direct physician access to quality and cost data, making the community's needs the priority, and a commitment to a single-tiered system where it's: Every. Body. In."

Cain said the AAFP will continue to work for its members, advocating for all Americans to have access to a family physician, making sure those same family physicians are fairly reimbursed and able to staff their practices with a steady influx of top-notch medical talent, as well as making sure insurers are fair to both patients and physicians. "When we combine the moral authority of our patients' stories with the now proven economic value of family medicine, we will be unstoppable," said Cain. "Together we will make certain the future is family medicine."