Sunday, July 31, 2011

Family Practice Rocks and other Cheers !

 

As I walk around my study, between thoughts about my blogs and social media lurking I am struck by the enthusiasm and total immersion of family medicine and it's cheering squad. Many young family medicine residents speak about a 'revolution' and regret the passage of what some of we older physicians lament....a long gone vision of an iconic Marcus Welby, indelibly marking our memories.

Featured statements such as, "Either you're at the table or you're on the menu." and other quotes from the blog, of the California Academy of Family Physicians (CAFP) as stated by Dr Roland Goertz, AAFP President, "Our time is now."

I have been a super specialist in the scheme of things....an ophthalmologist, now retired. I was strongly buffered and insulated from the vagaries of general medicine thanks to  family medicine doctors.. I know why I ran away from a great 'specialty' to ophthalmology after five years of general medical practice. I also read about these issues everyday. I was not  dedicated enough to stay with family medicine for my entire career. Late in my career after a heart surgery I made a temporary move back into family medicine, and found that I still enjoyed it greatly.

I think that specialists have been disloyal to general medicine as a whole, and have failed miserably to support general medicine as if specialists were a thing apart from medicine as a whole.

Granted medicine should not be lumped into one category, since each specialty is highly unique, requiring it's own paradigm clinically and administratively.

Admittedly there has always been 'the elephant in the room” a tension between specialty and PCP, not just in outpatient but in hospital between specialties, relevant to privileges and  relatively isolated from direct patient care, such as radiology, pathology anesthesiology.

As Jay W. Lee states; in regard to ACOs; Remember managed care in the 1990s? Remember how few physicians were truly engaged in the process? We do not have time to wait and see whether PPACA will live or die in our judicial system. We do not have time to sit back and hope that this will just pass us by like managed care did in the 1990s. Our time is now. Our leadership as family physicians is more crucial than ever before. We must not sit idly by and allow others to shape the health care system. We must revolt against the status quo.

"So..."
Last year, an inspired group of residents started a Family Medicine T-shirt Revolution. These t-shirts said things like: "Use all parts of your brain; be a family physician" and "Americans are dying to have a family doc." Their focus was on raising awareness, particularly among medical students, about the importance of family medicine and cautioning against being intimidated by academics, who have steered many bright students away from primary care.

           

Family Medicine’s Chief   Quarter Back

And remember as well that specialists are not all that happy either. Family practice is however set upon to provide much non medical administrative support for which there is no reimbursement, act as the 'triage' monitor the public health.

If family medicine goes away, it will also mean bad things for specialists. FPs deserve hardy specialist support. It has been sadly lacking in many cases.

PCPs must have a stronger place at the table of the RVU Committees.

So I say 'hug your referring physicians' and demand that their RVUs and CPT codes be adjusted accordingly..Don't be divided and conquered.

As I walk around my study, between thoughts about my blogs and social media lurking I am struck by the enthusiasm and total immersion of family medicine and it's cheering squad. Many young family medicine residents speak about a 'revolution' and regret the passage of what some of we older physicians lament....a long gone vision of an iconic Marcus Welby, indelibly marking our memories.

Featured statements such as, "Either you're at the table or you're on the menu." and other quotes from the blog, of the California Academy of Family Physicians (CAFP) as stated by Dr Roland Goertz, AAFP President, "Our time is now."

I have been a super specialist in the scheme of things....an ophthalmologist, now retired. I was strongly buffered and insulated from the vagaries of general medicine by family medicine doctors.. I know why I abandoned a great 'specialty' for ophthalmology after five years of general medical practice. I also read about these issues everyday. I was not strong enough, nor dedicated enough to stay with family medicine for my entire career. Late in my career after a heart surgery I made a temporary move back into family medicine, and found that I still enjoyed it greatly.

I think that specialists have been disloyal to medicine as a whole, and have failed miserably to support general medicine as if specialists were a thing apart from medicine as a whole.

Granted medicine should not be lumped into one category, since each specialty is highly unique, requiring it's own paradigm clinically and administratively.

Admittedly there has always been 'the elephant in the room” a tension between specialty and PCP, not just in outpatient but in hospital between specialties relatively isolated from direct patient care, such as radiology, pathology anesthesiology.

As Jay W. Lee states; in regard to ACOs; Remember managed care in the 1990s? Remember how few physicians were truly engaged in the process? We do not have time to wait and see whether PPACA will live or die in our judicial system. We do not have time to sit back and hope that this will just pass us by like managed care did in the 1990s. Our time is now. Our leadership as family physicians is more crucial than ever before. We must not sit idly by and allow others to shape the health care system. We must revolt against the status quo.

"So..."
Last year, an inspired group of residents started a Family Medicine T-shirt Revolution. These t-shirts said things like: "Use all parts of your brain; be a family physician" and "Americans are dying to have a family doc." Their focus was on raising awareness, particularly among medical students, about the importance of family medicine and cautioning against being intimidated by academics, who have steered many bright students away from primary care.

And remember as well that specialists are not all that happy either. Family practice is however set upon to provide much non medical administrative support for which there is no reimbursement, act as the 'triage' monitor the public health.

If family medicine goes away, it will also mean bad things for specialists. FPs deserve hardy specialist support. It has been sadly lacking in many cases.

PCPs must have a stronger place at the table of the RVU Committees.

So I say 'hug your referring physicians' and demand that their RVUs and CPT codes be adjusted accordingly..Don't be divided and conquered.

 

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