Fam Med Fridays

Your weekly update from the Missouri Academy of Family Physicians

Fam Med Fridays is the Missouri Academy of Family Physicians’ weekly member newsletter, bringing you the latest advocacy updates, CME opportunities, Academy news, clinical resources, member highlights, and important deadlines. Delivered every Friday, it’s your go-to source for staying informed and connected with Missouri’s family medicine community. Questions? Contact marketing@mo-afp.org.

Updated November 6, 2026

2026 Midterm Recap: What It Means for Missouri Family Medicine

Top 5 Things to Know

Republicans Retain Control, but Their Majorities Shrink

Republicans maintained control of both chambers despite significant losses. The Senate’s Republican majority narrowed to 22-12, while the House shifted to 95 Republicans and 68 Democrats. These changes could influence committee assignments, legislative priorities, and the ability to advance or block healthcare legislation.

Ballot Measures Could Reshape Healthcare Policy and Advocacy

The defeat of Amendment 3 maintains Missouri’s existing reproductive healthcare framework, while passage of Amendment 6 places new constitutional restrictions on legislative changes to citizen-approved ballot initiatives. These outcomes could influence both healthcare policy and the strategies organizations use to advocate for legislative change.

Physician Representation in the Senate Changes

Dr. Jon Patterson’s defeat in Senate District 8 represents the loss of an important physician perspective in the Capitol, particularly on scope-of-practice and family physician issues. The election of Dr. Sam Alexander, an emergency medicine physician from Springfield, creates an opportunity to establish a new relationship with a legislator who understands the realities of clinical practice.

Legislative Leadership Decisions Will Matter

House leadership appears relatively settled, while Senate leadership remains uncertain. The individuals selected to lead each chamber will help determine committee assignments, legislative priorities, and which healthcare proposals receive consideration during the upcoming session.

MAFP’s Advocacy Work Is Already Underway

Our legislative team will monitor leadership elections, committee assignments, legislative prefiling, and emerging healthcare proposals while strengthening relationships with lawmakers on both sides of the aisle. The engagement and clinical expertise of our Advocacy Commission and Board of Directors will be essential to these efforts now and early in session.

MORE DETAILS 

A Changing Legislative Landscape

Tuesday’s midterm elections brought significant changes to Missouri’s political landscape, with results that will shape the upcoming legislative session and potentially influence the future of family medicine in our state. While the anticipated Democratic gains exceeded initial projections, Republicans maintained majorities in both chambers of the Missouri General Assembly.

Republicans experienced notable losses in both chambers, although they will retain control heading into the 104th General Assembly. In the Senate, Republicans lost two seats, narrowing their majority to 22-12. The House saw a more substantial shift, with Republicans losing 16 seats, including 10 incumbent members, bringing the chamber’s partisan balance to 95 Republicans and 68 Democrats.  These changes will introduce new voices and perspectives into legislative discussions, potentially influencing committee composition, policy priorities, and the prospects for healthcare-related legislation.

For MAFP, maintaining strong, productive relationships with legislators on both sides of the aisle remains essential. Family medicine is not a partisan issue, and our advocacy efforts will continue to focus on policies that strengthen primary care, support physician-led healthcare teams, protect the physician-patient relationship, and improve access to high-quality care for Missourians.

Ballot Measures and Their Implications

Missouri voters also weighed in on constitutional amendments that could have significant implications for healthcare policy and the legislative process.

The defeat of Amendment 3 preserves the existing legal framework governing reproductive healthcare in Missouri. Meanwhile, the passage of Amendment 6 establishes new constitutional limitations on the General Assembly’s ability to modify or repeal citizen-approved ballot initiatives.  Although the full implications of these measures will become clearer over time, Amendment 6 in particular could change how organizations and legislators approach public policy advocacy and pursue legislative solutions.

MAFP’s legislative team will closely monitor these developments and evaluate their potential impact on issues important to family physicians, including the practice of medicine, patient access to care, and physician autonomy.

Physician Representation in the Missouri Senate

One of the most consequential election outcomes for organized medicine was the defeat of Dr. Jon Patterson in Senate District 8 by Representative Keri Ingle.

Dr. Patterson has been an important physician voice in the Missouri Capitol, bringing firsthand clinical experience and an understanding of the challenges facing physicians and patients to legislative discussions. His perspective has been particularly valuable as lawmakers consider issues involving scope of practice, healthcare delivery, and the regulation of medical practice. His absence from the Senate will be felt throughout Missouri’s physician community.

At the same time, the election of Dr. Sam Alexander, an emergency medicine physician with CoxHealth in Springfield, presents an opportunity to strengthen physician engagement within the Senate majority caucus. While our organizations and specialties may have different priorities on individual issues, a shared understanding of clinical practice and the importance of physician leadership provides a strong foundation for collaboration.

MAFP will prioritize building relationships with newly elected legislators, including Dr. Alexander, while continuing to engage returning lawmakers who have demonstrated an interest in strengthening healthcare across Missouri.

Legislative Leadership and What Comes Next

Attention now turns to the organization of the General Assembly, as legislative caucuses begin selecting leadership and establishing priorities for the upcoming session. In the House, Representative Alex Riley is widely expected to become Speaker, while Representative Jeff Myers is anticipated to serve as Majority Floor Leader, pending caucus confirmation.

Senate leadership remains less certain, with competitive races for President Pro Tem and Majority Floor Leader. These decisions will be particularly important because legislative leadership plays a significant role in determining committee assignments, managing the legislative calendar, and deciding which policy proposals receive consideration.

As these leadership positions and committee assignments take shape, MAFP’s legislative team will work to identify opportunities for meaningful engagement and ensure that family medicine has a voice in the conversations that will influence healthcare policy.

MAFP’s Advocacy Priorities Remain Clear

Although the political landscape has changed, MAFP’s commitment to representing Missouri family physicians remains steadfast.  As we prepare for the 2027 legislative session, our advocacy efforts will continue to emphasize issues central to the future of family medicine, including:

• Physician-led care: Protecting physician-led, team-based care and addressing proposals to expand the scope of practice of non-physician healthcare professionals.
• Primary care workforce: Strengthening Missouri’s primary care workforce through policies supporting medical students, residents, practicing physicians, physician recruitment, and physician retention.
• Administrative burden: Reducing unnecessary administrative and regulatory requirements that take time away from patient care.
• Access to care: Supporting policies that improve access to comprehensive, continuous, and coordinated primary care, particularly in rural and underserved communities.
• Physician-patient relationship: Preserving the physician-patient relationship and ensuring that clinical decisions remain grounded in medical evidence and professional judgment.

These priorities are not dependent on which political party controls the legislature. They reflect the needs of our members, the realities of practicing family medicine, and our responsibility to advocate for the patients who depend on us.

Moving Forward Together

In the coming weeks, MAFP’s legislative team will be actively monitoring leadership elections, committee assignments, legislative prefiling, and emerging policy discussions. We will work closely with our advocacy partners, engage legislators from both parties, and assess how these developments may affect Missouri family physicians and their patients.  Just as importantly, we will rely on the leadership, expertise, and engagement of our Advocacy Commission and Board of Directors.

Your experiences in exam rooms, hospitals, clinics, and communities across Missouri give our advocacy efforts credibility and purpose. As new legislative proposals emerge, we will look to you for insight into how these policies could affect the delivery of family medicine. We will also seek your assistance in building relationships with legislators, sharing patient care perspectives, and helping policymakers understand the real-world implications of their decisions.  A sample message you can copy, paste, and personalize is included below.  Feel free to reach out to your elected officials and offer to be a resource – they’ll appreciate it and you will soon become the voice of healthcare in your community.

Elections may change the individuals serving in the Capitol, but they do not change the importance of our mission. In fact, periods of transition create opportunities to introduce new legislators to family medicine, strengthen existing partnerships, and demonstrate the value that family physicians bring to Missouri’s healthcare system.

Thank you for your continued leadership and commitment to MAFP. Our advocacy is strongest when we work together, and I look forward to collaborating with each of you as we prepare for the opportunities and challenges ahead.

Sample Message

Dear Representative/Senator [Last Name],

Congratulations on your election to the Missouri General Assembly! Thank you for your willingness to serve our community.

As a family physician practicing in [Community], I have the privilege of caring for individuals and families across all stages of life. Every day, I see firsthand the healthcare challenges facing Missourians, from accessing timely care and navigating insurance barriers to managing chronic conditions and addressing the growing need for primary care.  As a doctor that cares about my patients, we share many of the same frustrations.

As you begin your legislative service, I hope you will consider me a resource on healthcare issues – specifically primary care. I would welcome the opportunity to share my perspective, answer questions, and help connect public policy decisions to the real-world experiences of patients and physicians in our community.

My patients are your constituents and I’m confident we share a common goal of improving their health and well-being.  I look forward to working together.

Congratulations again, and best wishes as you begin your service!

Sincerely,

[Physician Name], MD/DO
[Community]
[preferred phone number]
[e-mail]

Keep Pace with the Evolving Role of Lp(a)

You know cardiovascular risk assessment isn’t static. As the evidence and guidance around Lp(a) continue to evolve, understanding where testing fits-and what to do with the results-is becoming an increasingly important part of the ASCVD risk conversation. 

The AAFP, in collaboration with Decera Clinical Education, is offering a free live CME webinar that offers practical guidance on Lp(a) testing, interpretation, patient counseling and guideline-aligned management to help you put current recommendations into practice. 

Free live CME webinar: Tuesday, Dec. 1, 2026 | 6 p.m. CT
Lipoprotein(a) Is Actionable Today! Advancing Guideline-Aligned Lp(a) Screening and Management in the Primary Care Setting

An on-demand replay of the webinar will be available by January 2027. 

Register today and bring current recommendations into your practice.

Family Medicine Discovers RapSDI Research Grant Applications Now Open

Applications Due: Jan. 16, 2027 

Do you have members who are practicing family physicians out of residency and eager to explore research? The AAFP Foundation’s Family Medicine Discovers RapSDI research grant application is now open. Share this exciting opportunity with your eligible members today. 

The FMD RapSDI program, funded by the AAFP Foundation in collaboration with the DARTNet Institute, gives practicing family physicians the chance to lead short-term, high-impact research projects-no prior research experience required! 

Selected FMD RapSDI Scholars will receive mentorship and support to:

• Develop a research protocol
• Conduct project activities and analyze data
• Participate in research conferences
• Publish in a peer-reviewed journal

What’s at stake? 

Two physicians will be selected as scholars, and will each be awarded $40,000 for project costs or salary offset. Round 1 applications are due by January 16, 2027, at 5:00 p.m. CT. Eligible members can apply today following this link. 

Contact Ashlyn Ewing with questions. 

Students to Service Loan Repayment Program

Applications due November 19

The National Health Service Corps (NHSC) has opened applications for its Students to Service Loan Repayment Program through November 19, 2026. Eligible final-year medical students may receive up to $120,000 in tax-free loan repayment assistance in exchange for a three-year commitment to practice in a Health Professional Shortage Area. An additional $40,000 supplemental award is available for family physicians who regularly practice obstetrics and other eligible maternity care clinicians. 

The program helps family physicians launch their careers in high-need communities while reducing the burden of educational debt. Learn more about eligibility requirements and application resources through the National Health Service Corps before the November 19 deadline. 

Find Your Place in Family Medicine Leadership

MAFP will soon open application for members to attend the 2027 National Conference of Constituency Leaders (NCCL) in Kansas City, April 16-18. MAFP members are encouraged to bring their perspectives to leadership conversations and consider how they can contribute within your chapter and nationally. No fully mapped-out leadership plan is needed to get started. 

If interested, please register for the first in a series of three “NCCL Office Hours,” facilitated by the 2027 NCCL Advisory Group. This opening session is designed for members who are interested in leadership but unsure where to start, as well as those ready to explore their next leadership opportunity at NCCL in 2027.   

Find Your Place in Family Medicine Leadership will introduce ways to get involved in the AAFP, from chapter opportunities to national service through the National Conference of Constituency Leaders (NCCL). Members will explore leadership roles and ways to contribute through advocacy, mentorship and resolution writing. 

When: Thursday, November 19, 2026, 7–8 p.m. Central
Where: Virtual
How: Submit the registration form to receive a meeting invitation with event details. Registration must be submitted by November 16.

Join MO-CPAP Focus Group to Improve Pediatric Mental Health

Focus Groups: November 9-11

The Missouri Child Psychiatry Access Project (MO-CPAP), the statewide mental health initiative that helps healthcare, social service, and school professionals increase their knowledge, confidence, and capacity to address children’s mental and behavioral health needs in their settings, is inviting you to join a virtual focus group. The purpose of the focus group is to better understand the perceptions of providers participating in the program or providers considering participating in the program. They would like to learn more about any needs you may have and any barriers/challenges you may be facing. 

What to expect: 60-minute virtual group chat with about 8-10 other participants to share your open and honest thoughts.
When: November 9-11 – Choose the time that works best for you
Where: Online via Zoom
Thank you gift: As a token of MO-CPAP’s appreciation for your time, they will send a $50 virtual Amazon gift card after the session.  

Your answers and comments will remain completely confidential and will only be used to help improve the program. 

Please follow this link to confirm your spot:  https://redcap.link/mocpapfglistservs 

If you have any questions, contact Wendy Ell, Director Psychiatry Access Programs, at 573-884-1341 or ellw@health.missouri.edu. 

We Look Forward to Seeing You at the Annual Fall Conference!

Event Date: November 13-14

The 34th Annual Fall Conference is almost here, and we can’t wait to welcome our family medicine community to Margaritaville Lake Resort at the Lake of the Ozarks! We’re looking forward to two days of practical CME, engaging speakers, and meaningful opportunities to connect with colleagues from across Missouri. With up to 16.25 Live AAFP Prescribed credits available, including preconference programming, there’s plenty to look forward to!

Haven’t registered yet? There’s still time to join us! We hope to see you at the Lake.

Don’t Miss the OMT Preconference Workshop! Join us Thursday, November 12, for Joy in DOing: Practical OMT for Your Practice and Your Patients, a hands-on workshop offering up to 4 AOA Category 1-A credits. Separate registration is required, even if you’re already registered for the Annual Fall Conference. MAFP and MSACOFP members can attend for $150, and non-members for $200.

See the full schedule at www.mo-afp.org/annual-fall-conference.

Annual Fall Conference Registration | OMT Workshop Registration

Call for Presentations: Annual Fall Conference Proposals Due in December

MAFP is seeking engaging, practical presentations for the 2027 Annual Fall Conference. Share your expertise or encourage a colleague to submit a proposal and help bring valuable education and fresh perspectives to Missouri’s family medicine community.

35th Annual Fall Conference
September 10–11, 2027 | Union Station, St. Louis
Proposal deadline: December 20, 2026

We welcome presentations across the full scope of family medicine, including preventive care, chronic disease management, pediatrics, geriatrics, women’s and men’s health, behavioral health, musculoskeletal medicine, office procedures, practice efficiency, and physician well-being.

Sessions should be practical, interactive, and grounded in everyday patient care, offering strategies family physicians can put to work when they return to clinic.

Have an idea or know a great presenter? View the call for presentations and access the submission form.

Questions? Contact Andrea Holloway, MAFP Member Experience Manager, at aholloway@mo-afp.org.

Free CME to Help You Put CGM into Practice

Every day you help patients manage the challenges of diabetes. Continuous glucose monitoring (CGM) can provide you and your patients with valuable information to guide treatment decisions, support shared decision-making and improve diabetes management. As diabetes technology evolves and coverage expands, the need for updated and evidence-based education on CGM is increasing. 

The updated AAFP TIPS™ on CGM course offers 2.75 credits of free, on-demand CME to help you make CGM work in your practice. Learn how to identify patients who may benefit, assess readiness, interpret CGM data and talk with patients about the benefits and limitations of the technology. 

You’ll also explore practical strategies for integrating CGM into your care team’s workflow, including staff roles, billing and coding, documentation and authorization. 

Access Free CME 

Tools That Make Vaccine Conversations Easier

Your recommendation remains one of the strongest influences on whether a patient chooses to be vaccinated. That’s especially important as you care for older adults and patients at higher risk for serious illness from influenza and COVID-19.

To guide those conversations, the AAFP has developed patient-friendly conversation guides that make it easier to encourage shared decision making and meaningful discussions during office visits. These easy-to-use tools can help you explain vaccine recommendations, answer patient questions and build confidence.

Explore these resources and incorporate them into your workflow this season. They offer another practical way to support the trusted conversations you have with patients every day.

Download the influenza and COVID-19 conversation resources.

Family Medicine Advocacy Rounds – October 2026

Welcome to Family Medicine Advocacy Rounds — the American Academy of Family Physicians’ monthly tip sheet to educate, engage and update you on the latest policy issues affecting family physicians and their patients. 

Kisha Davis, MD, MPH, FAAFP, was installed as president during the Congress of Delegates meeting in Nashville earlier this month. 

 As a family physician and public health advocate, Dr. Davis brings a deep commitment to advancing health equity, strengthening care delivery and mentoring the next generation of family physicians.  

“I’ve always valued having a foot in both the policy and clinical worlds. They inform each other, and each makes the other stronger,” said Davis. “Everyone deserves a family physician—someone who knows about diabetes and depression, the medical history and the story behind it. Through that firsthand experience, we see what works, where barriers remain and what communities need to thrive. Family physicians can bring those perspectives to the policy table to build a health care system that works better for everyone.” 

Read our full press release here.  

Family Physicians: HHS Must Remove Barriers to Treating Congenital Syphilis  

Earlier this month, Davis spoke at an HHS event focused on congenital syphilis. She emphasized that congenital syphilis is preventable, but prevention requires more than screening. Patients need timely treatment, follow-up, partner services, and coordinated care. 

She also emphasized that family physicians often encounter patients before, during, and after pregnancy and can play a critical role in identifying infection and connecting patients to care. 

HHS can help patients by supporting medication access, strengthening public health capacity and care coordination and addressing payment and coverage barriers that delay care. 

AAFP to FCC: Improve Telecommunications and Telehealth Services 

Why it matters: Accessible telecommunications and telehealth services have become increasingly important as rural communities confront a shrinking primary care workforce.  

Family physicians have long advocated for reliable connectivity, which helps rural practices to access electronic health records, prescribe medications, exchange clinical information, coordinate care, provide telehealth services and support remote patient monitoring. Connectivity also enables family physicians to maintain continuity with established patients that may not otherwise be available locally.  

What we’re working on: 

• The AAFP led a joint letter with the Council of Academic Family Medicine to the Federal Communications Commission urging them to support accessible telecommunications and telehealth services in rural settings. We recommended that the FCC: We recommend the FFC: 
• Use existing federal definitions of rural areas to make the program simpler and more consistent 
• Make sure telecommunications funding meets the needs of the most remote and underserved rural, Tribal, frontier and isolated communities 
• Treat backup internet service as essential for patient safety, continuous care, telehealth and physician training 
• Do not place added compliance burdens on rural physicians if contract requirements change 
• Keep enough data to measure access, participation and fairness before removing Healthcare Connect Fund reporting requirements 

Leading Physicians: AI Cannot Replace Us 

AI should support, not replace the patient-physician relationship. The AAFP joined the American Medical Association and other physician groups in rejecting claims that AI is broadly superior to physicians, or that physicians cannot be trusted to make clinical decisions without consulting it. These claims misrepresent the evidence and risk undermining patients’ trust. 

We will continue advocating to ensure AI never becomes another tool for denying care, increasing administrative burden or undermining physician judgment and the patient-physician relationship. 

AAFP Urges Senate to Improve Access, Affordability 

Why it matters: Health care reforms are needed to improve access and affordability for patients. This issue continues to be top of mind for family physicians and the communities, families, and individuals they care for all across the country.  

What we’re working on: The AAFP provided the Senate Finance Committee with recommendations to improve coverage, access and affordability for patients. 

Our letter highlighted the need for policymakers to: 

• Establish a national standardized primary care benefit with either no or reduced cost-sharing 
• Increase investment in primary care 
• Improve continuity of care across coverage transitions 

It also outlines recommendations to address prior authorization, claims denials, insurer transparency, corporate consolidation, vertical integration, and administrative burden while strengthening support for independent physician practices and direct primary care models.  

Family Physicians Stress Need for Menopause Care Training 

The AAFP submitted a statement for the record in response to a recent Senate Aging Committee hearing on closing the menopause care gap. Our letter noted the evolving nature of menopause care guidelines and the urgent need to invest in training physicians to provide up-to-date menopause care. We also called for more research to expand access to evidence-based care and highlighted the ongoing role of the Agency for Healthcare Research and Quality (AHRQ) in ensuring evidence-based menopause guidelines are implemented into practice.  

Department of Homeland Security Releases New H-1B Proposed Rule 

Why it matters: The U.S. Department of Homeland Security has proposed a $103,265 fee for cap-subject H-1B petitions, on top of existing filing fees. If finalized, the fee would represent one of the most significant increases in employment-based immigration filing costs in U.S. history.  

The proposal follows recent litigation that blocked the administration’s earlier effort to require a $100,000 payment for certain H-1B workers entering from abroad. The new proposal would apply broadly to cap-subject H-1B petitions regardless of where the worker is located. 

Most internationally trained physicians on H-1B visas are cap-exempt, meaning this proposed fee generally would not apply. Cap-exempt employers typically include institutions of higher education, qualifying affiliated nonprofits, and certain government and nonprofit research organizations. For family physicians and practices, the key question is whether employers qualify as cap-exempt.  

What we’re working on:  

• The AAFP led a sign-on letter to the Department of Homeland Security and urged the agency to: 
• Recognize physicians, dentists and trainees as serving a permanent national medical interest warranting special consideration under H-1B policies.  
• Establish a permanent exemption for physicians and dentists from H-1B-related fees and restrictions, regardless of whether the petition is cap-subject or cap-exempt.  
• Continue efforts to improve visa processing efficiency and reduce administrative barriers affecting physicians, residents, fellows, researchers, and other medical professionals.  
• Work with Congress to advance durable legislative solutions, including the H-1Bs for the Physicians and Healthcare Workforce Act (H.R. 7961). 

AAFP Asks FDA to Ensure Physicians Lead on AI in Medical Devices 

Why it matters: Clinical AI should support, not replace, physician judgment and should never be allowed to weaken the patient-physician relationship. Physicians need enough information, time, authority and practical ability to review, change, reject, or reverse an AI-influenced clinical action. 

What we’re working on: 

• The AAFP wrote to the FDA and urged the agency to keep physicians at the center of clinical AI oversight. We recommended that the FDA: 
• Use a risk-based approach that protects patient safety, equity, privacy and trust—while ensuring physicians can review, change or reject AI-driven clinical actions. 
• Test AI in real-world settings and judge risk by what a tool does, its potential harm and whether users can verify and correct its output. 
• Require strong evidence, ongoing monitoring and manufacturer accountability, with added safeguards for AI that can act independently. 

 AAFP Asks CMS to Improve Medicaid Interoperability 

Why it matters: Better interoperability can reduce fragmented care and make it easier to share health information without adding administrative burden. The AAFP has long advocated for regulations that foster successful Medicaid modernization. This requires consistent standards, input from key stakeholders and practical implementation for physician practices. 

What we’re working on:  

• The AAFP wrote to CMS and urged the agency to:  
• Support flexible, standards-based interoperability 
• Prioritize real-world testing and implementation support 
• Align Medicaid technology requirements with broader federal interoperability efforts to improve care coordination and patient outcomes.  

What We’re Reading: 

• AAFP EVP and CEO, Shawn Martin, and Dr. Kyu Rhee, CEO of the National Association of Community Health Centers, wrote an op-ed in Fierce Healthcare making the case for a Primary Care Triple Double. “We are applying those principles to healthcare: double investment in primary care, double the reach of primary care, starting with community health centers, and double the share of clinicians entering primary care. Our ask of lawmakers is to align policy, financing and recruitment efforts around what we know will help patients: better access to community-based primary care.” 
• Is AI coming to the Medicare Annual Wellness Visit? MedPage Today cites AAFP’s letter on the 2027 Medicare physician fee schedule proposed rule.  
• AAFP’s SVP of external affairs and practice experience, Stephanie Quinn, wrote an op-ed on how direct contracting can put health care dollars back to work.