Family Medicine Revolution: The Fire Within (Part II)

Catching Fire In the second book of the Hunger Games trilogy, a rebellion begins to catch fire in post-apocalyptic Panem. Likewise, the Family Medicine Revolution is beginning to catch fire in the U.S. health care system. Here are three reasons why I believe that the #FMRevolution fire is catching and will continue to burn brightly: 1. Health care reform is here to stay. With SCOTUS ruling in favor of the constitutionality of PPACA and President Obama’s re-election, health reform will not die. The truth is, whether or not these two events happen, health reform has changed the vector of our health care system inexorably. With change, comes fear and opportunity. Do we choose fear or do we choose opportunity? Historically, doctors have chosen fear over opportunity, purposely choosing not to be involved in system change because of this old, tired line of argument: “We’re doctors and politics doesn’t suit us.” Well, if we want the health care system to do what we want it to do, i.e. deliver patient-centered care, damn, the politics: we physicians must be the leaders that the health care system needs us to be. In other words, if you’re not driving, then prepare to be run over (a twist on “if you’re not at the table, then you’re on the menu”). 2. The purchasers of health care believe that primary care is the key to a high value system. This past spring, I was boarding my flight to Kansas City to chair the 2012 AAFP National Conference of Special Constituencies. Standing in the Southwest boarding queue behind me was Dr. Paul Grundy. Once we recognized each other, Dr. Grundy asked me to save him a seat on the plane (how awesome is it that IBM’s Global Director of Healthcare Transformation flies Southwest?). Over the next four hours, he and I had the opportunity to dialogue about the state of primary care. What became clear to me is that Paul gets the value of primary care and more importantly, he is leveraging his position of power and authority at IBM to see that others understand it too. One anecdote was particularly powerful. In regards to his company’s request for proposals on employee health care plans, it is written to maximize the likelihood of insurance plans offering and/or developing products to ensure that the goals of a patient-centered medical home are met. This strategic decision was made because the data backs it up. Furthermore, Dr. Grundy has extended his audience to include other purchasers of health care to “end medical homelessness.” 3. Medical students see that they can become the physicians that they wrote about in their personal statement. Just this week, our friends at Primary Care Progress posted a blog post on “The True Story of Primary Care.” In it, Baylor medical student Joe Nelson writes:

“Students are never told the true story of primary care: that it can be whatever we make it. Emerging new models, such as the patient-centered medical home, change the way primary care is practiced and reimbursed, increasing quality for patients and job satisfaction for physicians and lowering costs for all.”

This perfectly captures the spirit of Family Medicine Revolution. Family Medicine is innovative because we are reinventing ourselves to leverage today’s information technology to become the 21st century primary care physician: two parts Marcus Welby and one part Steve Jobs. Together, we must share our narrative in order for the health care system to allow us to become the physicians that we wrote about in our personal statements. Viva la #FMRevolution! We are #District12. In the third and final blog post on The Fire Within, I will address how we use social media to tell our story. #FMRevolution

Author: Jay Lee, MD, MPH

Jay W. Lee, MD, MPH, FAAFP, is Associate Medical Director of Practice Transformation at MemorialCare Medical Group and Assistant Program Director/Director of Health Policy at the Long Beach Memorial Family Medicine Residency Program. He is also Speaker on the California Academy of Family Physicians' Board of Directors.

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