Since 1927, Time Magazine has recognized a person, group, or entity, who or which “most affected the news and our lives, for good or ill, and embodied what was important about the year.” Previous concept designees have included the Middle Americans, American Women, the computer and the Endangered Earth. Let us look ahead to 2014 and delineate why the family physician is the clear choice for this distinction. With further implementation of the Affordable Care Act, 30 million people will be eligible to purchase health insurance. By comparison, 19 million people enrolled during the first year of Medicare in 1966. The Centers for Medicare and Medicaid project that the United States will spend $3.1 trillion dollars on health expenditures, consuming 18.2 percent of our Gross Domestic Product.
Family physicians will be the ones greeting these new enrollees to a new way of life. We will serve as ambassadors, guides, mentors, educators and guardians. We will be the agents fulfilling the promise of health insurance by providing access and care. Moreover, we shoulder the responsibility as financial stewards. More enrollees equates to greater service demands increasing costs. We cannot view expenditures through the ledger’s lens of black and red ink. We must direct resources as investments in people’s lives and futures. In this upcoming period of social, financial and medical upheaval, people are seeking a reassuring compass to navigate through the unfamiliar and the unknown. Family physicians have always prioritized continuity of care and strengthening personal relationships with patients. Our values will provide a true north and a beacon to those awakening from uninsured and marginalized to insured and mainstream.
Medical costs are the leading cause of personal bankruptcy, accounting for 62 percent of filings, although 78 percent of these individuals had medical insurance. Thus, medical insurance by itself is not a panacea. Family physicians are still are needed to elevate paper into purpose. This transformation stems from active engagement and partnership with our patients. Our responsibility and scope of influence in 2014 will increase exponentially.
Movements need harmony and synergism to make the local global and global local. I have asked for help from all parts of the country to advance #2014yearfp. I draw some lessons from the Occupy Wall Street movement. It was topical, but not sustainable. We must seize the moment and reinvigorate the perception of the family physician for the long run. Others will not do this. We must take ownership. Be visible, be vocal and be vibrant. We must go forth with a message that is clear, concise, consistent and compelling. That message is unless we come together and become a cohesive force for true social innovation, we will quicken the demise of the sacred physician-patient relationship. Have the stakes ever been higher for a make-or-break moment outside wartime? As a nation, we will be challenged to accommodate all of our fellow citizens’ medical needs. This is not a time to be divided and to compete for resources. This is the time to unify and make the common good exceptional great.
To have a galvanizing effort, we need to take to the streets of cyberspace and educate the editors of Time that the family physician is the right choice for Person of Year in 2014.
Go forth, take a stand and stand out. Arise and lift those who are in need. Do it for your patients, neighbors and for the future. I believe it is our moment to shine as family physicians. Do not let it pass you by. Write your legacy from the inkwell of sweat. Our voices should be hoarse from staying on message and our fingers calloused from typing and texting.
Dr. Fong is director of the UC Davis Family Medicine Residency Network. His opinions are his own and do not represent UC Davis. He can be reached at ronald.fong@ucdmc.ucdavis.edu.
