You may recall that when I took the office of president, I pledged to visit family physicians in every MAFP district. On Wednesday, August 22, Kathy Pabst and I kicked off these “Can I Come Over” visits in Kansas City and it was a busy, informative day! Thank you to Drs. Afsheen Patel, Beth Rosemergey, Anne Arey, Mark Byler, John Burroughs and Wael Mourad for donating a portion of their day to us. We spent anywhere from 30 to 90 minutes with each physician chatting about what MAFP is currently and plans to do but mostly we just sat back and listened to their stories. These six family physicians represented diverse backgrounds and clinical settings in academic medicine, charitable medicine, employed practice, independent practice and public health.
Through the day, common themes emerged. Nearly everyone spoke of their specialty as a calling. Nearly everyone was a teacher of medical students or residents in some way. And nearly everyone noted challenges with administrative burden (particularly being asked by employers or insurance companies to focus on more activities and measures without being provided more support or staff at the same time), EHR inefficiency and work compression.
Other insights were unique. Dr. Burroughs, for example, is participating in CPC+, a pilot model of payment reform from the Centers for Medicare and Medicaid Services that pays care management fees and performance-based incentives, with which practices are encouraged to innovate around access, continuity, care management, cost-effectiveness and value-based care. In his own practice, Dr. Burroughs has expanded office hours, offered group visits and hired more staff to focus on population management.
This group was also ready with ideas for solutions! Just a few of the suggestions were:
- Employers paying physicians a stipend or hourly wage for administrative time unrelated to patient care or RVUs
- Identify key legislators on issues or committees relevant to patients of family physicians and encourage them to solicit the opinion of not only their constituents but also of their own family doctor on issues relating to health care
- Encourage family physicians to be the decision-makers for their practice setting by becoming a hospital, clinic, university administrators, and leaders
The group also represented well the idea that family physicians do really cool things! Dr. Byler, for example, spent a significant portion of his career as an American expatriate practicing in Zimbabwe, which lends a unique perspective to his current work teaching family medicine residents at UMKC Truman Residency. Dr. Burroughs, it turns out, is a certified yoga instructor and leads yoga classes for some patients. And in 2008 Dr. Mourad established a free weekend clinic, the Medina Clinic, in Kansas City that has now grown to full-time, staffed by volunteer physicians and providers. We had an engaging conversation about charitable medicine. I volunteer at a free clinic in St. Louis and both Dr. Mourad and I have noticed that nearly every family medicine resident who has accompanied us seeing patients in these settings concludes the day by saying, “This. This is why I went into medicine.”
Overall, Kathy and I found the day inspired a number of potential courses of action! We’ll be bringing these ideas to Sarah and Becky back at the MAFP office and to the other members of the MAFP Board because our goal is for every Missouri family physician to be able to say, “This. This is why I went into medicine.”
