The Affordable Care Act will facilitate health insurance coverage for 30 million additional family members, neighbors, and co-workers by 2014. Unfortunately, they will compete for access to a primary care pool with a projected 30,000 provider shortfall.
Family physicians number 100,000 in the United States. But, are we 100,000 strong? Can we elevate our diversity into unity and assume the lead responsibility in addressing this crisis? Dire times implore us to champion the big hairy audacious idea or the disruptive innovation. We need to channel our passion into a purpose and to refine our voice into a narrative. I propose we prepare throughout 2013 to anoint 2014 as the Year of the Family Physician [#2014yearfp].
This is the first in a blog series launching a manifesto for widening our base. Imagine healthcare discussions from the kitchen table to Capitol Hill punctuated with family physicians as the consensus focus. This movement needs more than our voices; otherwise, the public may perceive our efforts as self-serving. We recruit through identity expansion without dilution. Our core identity is the physician for all stages of life. However, that perspective misses the depth and range of our contributions. Family physicians power economic stimulation and practice fiscal stewardship. A Graham Center report calculated that family physicians were responsible for a $46 billion economic boon to their service communities in 2009.1 Compared to specialists, we provide healthcare at lower costs while achieving better health outcomes. We share with unions, civic organizations, chambers of commerce, and trade associations that our added value to communities extends beyond healthcare. When others bond with us and contribute to family medicine’s narrative, Congressional committees and legislators cannot afford to remain ignorant or indifferent to family medicine’s mission. Yet, this movement transcends policy and legislation.
We have the opportunity and duty to design the memes and zeitgeist of healthcare for the remainder of the decade. We can influence the social norm to define family medicine not as primary care, but prime care. Reforms in reimbursement and medical school admission preferences will take time and be hierarchical in nature. But, we can reshape culture in 140 characters. We are 100,000 strong because we treat the coal miners of the Appalachians and the ranchers of the Black Hills. I call upon every family physician to grow this movement with personal stories of engagement that no other medical disciplines can tell. Connect with all those you encounter and enrich the movement in a local and horizontal manner. Garage bands, street poets, and open mics will be our messengers.
We need to dream in epic proportions and leave legendary legacies. If my proposal seems too grand, too undisciplined, and too scant in detail, then I plead guilty. Yet, these perceived shortcomings are the keys to prevent the movement from fading into a fade. This is not my movement. This is a movement of all family physicians and their patients. This is based on collaborative ownership where no voice is silenced, no vision obstructed, and where we achieve advancement without leaving anyone behind. I am asking for your help, your belief, and your commitment in making a lasting change in how our nation views healthcare and family medicine.
On New Year’s Eve, celebrate the beginning of an epoch. Feel the power of a movement as close as your heartbeat and as far-reaching as the stars. Start the fire that will warm millions and disperse the darkness of disparities. See the tide turn when architects, bakers, masons, and parents petition their elected officials at every level to declare 2014 the Year of the Family Physician.
The next blog: specifics and examples.
