Kathryn Freeman, MD
This past spring, I consciously moved away from learning clinical skills and spent time at two conferences: the National Medical Legal Partnership Conference, and the Family Medicine Advocacy Summit. There, instead of learning about medicine, I learned about stories.
When I reflect on what I learned in medical school, it was all about taking a patient story and converting it into a formal presentation. We spend years training our residents to boil down a patient’s history into discrete facts in a defined structure, using medical terminology to convey a message that only other physicians can understand. But that only allows us to communicate with each other, not with the world around us, or with the people, partners, groups, and leaders who have the potential to make a larger impact our patients’ health.
Hope Wittenberg, MA Director, Government Relations
When one thinks of the repeal of the Affordable Care Act (ACA), the major tax and coverage provisions required by insurance come to mind. Efforts by the new Trump Administration and Congress to repeal the ACA will obviously have a tremendous impact on these features of the law.
What is less known is other provisions of the law, many of which have an impact on academic family medicine–they affect workforce or primary care research, or both. These issues do not have large constituencies behind them–we may be alone or in slim company trying to maintain key portions of the law that impact our academic infrastructure.
Academic Primary Care Provisions in the Affordable Care Act
- Establishment of payments for training provided to Teaching Health Centers, rather than hospitals
- Reauthorization of Title VII Primary Care Training and Enhancement with an emphasis on the patient-centered medical home
- Primary Care Extension programs to assist primary care practices regarding innovations and best practices
- Medicare Graduate Medical Education (GME) provisions supporting community-based training within the confines of historic GME
- Establishment of the Patient-Centered Outcomes Research Outcomes Institute (PCORI), to improve patient care and outcomes through comparative clinical effectiveness research
- US Preventive Services Task Force (USPSTF) gained a new requirement that private insurance plans cover recommended preventive services without any patient cost-sharing
A Campaign We Must Not Lose
Assuming others will make the case for us is not an option. Working in partnership, STFM and the other CAFM organizations, along with our members, will need to actively engage on our key issues. If each of us does not get involved, we may not have the political might to support our position(s.) We do not have the luxury of large population size to assume that others will make the case for us. Members of Congress need many voices educating them about what we know–that the overall health of a population is directly linked to the strength of its primary health care system and workforce. They need to hear why each of these provisions is important to the primary care infrastructure of the United States.
Paul Gordon, MD, MPH recently started his two-month bicycle tour from the Washington, DC to Seattle, stopping along the way to learn what people think of the Affordable Care Act. On his journey, called the Bike Listening Tour, Dr Gordon will visit small towns across the nation and record interviews with locals about their thoughts on the Affordable Care Act.
Watch the video below to hear from Dr Gordon about his trip.
To learn more about the Bike Listening Tour and to follow Dr Gordon during his trip, read his blog at https://bikelisteningtour.wordpress.com.