Saturday, March 07, 2009

Keep The Faith

When I arrived this morning in Sacramento, I wasn't sure why I was here. I am attending the California Academy of Family Physicians 2009 Congress of Delegates. I am one of many family physicians who have come from all over the state. They are leaders in their community, faculty in academic medicine and residency programs, department chairs, chapter presidents.

I am here because I happen to show up at most of the meetings. If you go often enough, you get nominated to be a delegate. This year especially there weren't enough of us coming from the Los Angeles Chapter so they asked for volunteers. At the registration table, my name was not listed as one of the delegates. Maybe I don't belong here.

The guest speaker is Dr. Ted Epperly, the current president of the American Academy of Family Physicians (AAFP). He notes the current national crises (crisises? crisii?) and says that he believes that, after many years of failed attempts, healthcare reform is finally going to take place in 2009 because of a miracle. According to Epperly, that miracle was the election of Barack Obama.

He said that he was at the White House 2 days ago, invited along with representatives from the 3 other primary care specialties (American College of Physicians, American Academy of Pediatricians, American Osteopathic Association) and a host of legislators, insurance representatives and stakeholders. They were part of a White House Health Care Summit there to discuss how to fix what ails our nation's medical non-system.

During the summit, Obama asked for the cooperation and participation from all the interested parties. And when he came to physician participation, he called on Epperly (who was taken by surprise and only had about 20 seconds to speak).

What he said was:
"Speaking on behalf of over 100,000 doctors, we're ready to do our part. We very much believe that we need to expand coverage in this country to everyone, and we need to fix the work force, sir, so that all those patients have a place to go.

We'll roll up our shirtsleeves and do everything possible to make this work. Because it is the right thing to do, and I applaud you and this body for doing this today, to do it this year. And we must do it. Thank you."

Epperly said he feels it was not by accident that Obama chose a family physician to speak for American physicians. It’s because he understands that primary care is broken.

He also said the president made it clear that everyone must be at the table, everyone must listen and everyone must give up a little something. Epperly quoted Victor Fuchs, a noted Stanford economist, as saying US healthcare reform would only come about if there was a war, an economic depression or major civil unrest. (We got 2 out of 3 so far.)

The Patient Centered Medical Home (PCMH) has become more than a model of healthcare, Epperly said. It has become a symbol of a movement to restore healthcare to this country.

Epperly observed that the current healthcare system is totally unsustainable, especially in this recession. Healthcare spending rose to $2.4 trillion in 2008 and is projected to rise to $2.5 trillion in 2009. But Epperly is hopeful that reform will finally take place under the Obama administration. "More has been done in one month than has been done in the past decade as far as healthcare reform," he said. "We can't afford to keep putting it off. President Obama recognizes that if there isn't enough investment in our domestic policy, this country will fall apart."

Epperly also called on family physicians to take a more active role in advocating healthcare reform. "If you're not at the table, you're on the menu," he said. "We family physicians are in the position we are in, not because the work we do is not worth it, but because we didn't step forward when we needed to."

Even though family physicians may feel like they're not getting the respect or the payment that they deserve for their work, Epperly feels Obama recognizes the value of family physicians to care for patients and their community. "Don't lose faith," Epperly said. "It won't be easy, but a better day is coming."

At the end of Epperly's talk, I felt re-energized and motivated, hopeful that our healthcare system can and will change for the better, sooner rather than later. I will continue to try to improve my solo practice using the principles of the PCMH. And while I don't have the charisma, eloquence or leadership of Obama or Epperly, I can blog.

I guess I figured out why I am here in Sacramento after all:

To keep the faith. And to help Save Primary Care.