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40th Annual Spring Conference
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Thursday, April 26
8:30-10:00 am
“Moving Family Medicine Forward: Making Vision a Reality”
Terry McGeeney MD, MBA, TransforMED, Leawood, Kan
The Future of Family Medicine report painted an ominous picture for family medicine and primary care in the United States. If things did not change, the future of the specialty many of us have committed our lives to was bleak. It was also recognized that as family medicine goes, so goes the US health care system. The family medicine “family” viewed the FFM report not as gloom and doom, but a challenge to be accepted and met. FFM created a vision as to what family medicine should become and TransforMED has moved that vision to reality. The model of care described in the FFM report has now been clearly defined and is being implemented. A National Demonstration Project is ongoing to test the new model. A Residency National Demonstration Project, P4, is in progress to identify and test new innovative ways to train family physicians to empower them to practice the new model when they leave their residencies. Most importantly, family medicine has the opportunity to be a leader of innovation and progress in the US health care system. With leadership comes responsibility. The responsibility to succeed. During this presentation we will review the vision, update the progress, and renew the enthusiasm for the opportunities presented to us.
Dr McGeeney brings nearly 30 years of experience as a board-certified family physician and a solid understanding of the fundamentals of business management and health facilities organization and operations, which he acquired while earning a master’s degree in health care administration from the University of Colorado. Most recently, Dr McGeeney served as assistant medical director and then medical director of the McFarland Clinic PC, central Iowa’s largest physician-owned, multi-specialty clinic. The McFarland Clinic PC network of more than 200 health care providers annually serves more than 900,000 patients in 24 Iowa communities. A forward-practicing, patient-focused clinic, McFarland has in place many of the new model concepts, which were implemented under Dr McGeeney’s leadership. A testament to the efficacy of these concepts, McFarland’s family physicians’ average income is significantly more than the national average.
As president and chief executive officer of TransforMED, Dr McGeeney serves as the leader, visionary, and key spokesperson for the company. The initial focus of TransforMED is to develop, implement, and evaluate a “proof-of-concept” National Demonstration Project to pilot test a new model of care in 20 family medicine practices of varying sizes across the country. Pilot practices will implement fully all elements of the new model and undergo thorough, real-time evaluation to determine empirically the model’s impact on the quality of care and business performance. A final report is expected in early 2008.
Future plans call for TransforMED to expand its service offerings to primary care physicians across the country, providing them with fully integrated and prepackaged products and services, including expertise and experience implementing the new model with ease. By forging partnerships with technology vendors, developing customized and integrated product and service packages, refining existing products to meet family physicians’ needs, and providing consultation, advice, and training to practices, TransforMED will assist primary care practices in transitioning to the new model of care.
Friday, April 27
8:30 - 10:00 am
2007 Blanchard Memorial Lecture:
“A Community Leading Change–Fulfilling the STFM Vision”
Kevin Grumbach, MD, University of California, San Francisco
The vision statement of STFM affirms the role of the Society as an agent of change: “We will be a community of educators, researchers, and clinicians leading change that measurably improves the health of all people.” There tends to be broad agreement among STFM members about the overall panorama of this vision, a panorama featuring universal coverage for all Americans, a strong infrastructure for education and practice in family medicine, and new models of primary care that deliver accessible, effective, and efficient care. However, achieving consensus can be more challenging when it comes to more precisely defining what this future should look like and the strategies to achieve reforms. What is the best way to achieve universal coverage? Will family physicians of the future still be expected to “do it all,” or will their work involve a very different set of tasks from those of the traditional family physician? Will a 2-year residency, a 4-year residency, or a residency of flexible duration best meet the training needs of the future? This presentation will concern itself less with attempting to provide answers to these questions, than with exploring how STFM can most productively promote a dialogue about how to fulfill its vision to “lead change.” The presentation will address the need to define core values, accept the risks and uncertainties involved in creating transformative change, achieve civility of discourse that respects diversity of opinions, and challenge ourselves to heed Gandhi’s call to “be the change you want to see in the world.”
Kevin Grumbach, MD, is professor and chair of the Department of Family and Community Medicine at the University of California, San Francisco and chief of family and community medicine at San Francisco General Hospital. He is the director of the UCSF Center for California Health Workforce Studies, codirector of the UCSF Center for Excellence in Primary Care, and codirector of the Community Engagement Program for the UCSF Clinical Translational Science Institute. His research on topics such as primary care physician supply and access to care, racial and ethnic diversity in the health professions, and the impact of managed care on physicians have been published in major medical journals such as The New England Journal of Medicine and Journal of 14 Questions? Contact Priscilla Noland at 800.274.2237 • stfmoffice@stfm.org • fax: 913.906.6096 • www.stfm.org 15 the American Medical Association and cited widely in both health policy forums and the general media. With Tom Bodenheimer, he coauthored what has become the best-selling textbook on health policy, Understanding Health Policy—A Clinical Approach, and the recent book, Improving Primary Care – Strategies and Tools for a Better Practice. He received a Generalist Physician Faculty Scholar award from the Robert Wood Johnson Foundation, the Health Resources and Services Administration Award for Health Workforce Research on Diversity, and in 1997 was elected a member of the Institute of Medicine, National Academy of Sciences.
Dr Grumbach is cochair of the UCSF University-Community Partnership Council, and a founding member of the California Physicians’ Alliance, the California chapter of Physicians for a National Health Program. He practices family medicine at the Family Health Center at San Francisco General Hospital.
Saturday, April 28
8:30-10:00 am
“Can Family Medicine Become a Learning Community?”
James Mold, MD, MPH, University of Oklahoma
.A “learning community” is one in which the members strive continually to improve what they are doing and feel an obligation to share what they have learned with all other members of the community. Learning that occurs as a result of systematic observation, analysis, and experimentation is called research. Using examples from his 12-year experience directing a practice-based research network in Oklahoma and several other stories, James Mold, MD, MPH, will attempt to make the case that family medicine is well-positioned to become a learning community. He will then discuss some of the steps we would need to take to accomplish it. In 1968, family medicine set out to revolutionize health care delivery in this country. Let the revolution resume!
Dr Mold received his MD degree from Duke and completed a family medicine residency at Highland Hospital/University of Rochester. He served for 6 months in a small village in rural Ghana, West Africa before joining a practice in Hillsborough, NC, where he practiced the full spectrum of family medicine for 6 years. He then joined the faculty in the Department of Family Medicine at the University of Oklahoma, focusing first on predoctoral education and then on developing geriatric training opportunities for the residents. During this time he completed a part-time geriatric fellowship offered through the University of North Carolina and obtained a Certificate of Added Qualifications in Geriatric Medicine. He directed Oklahoma’s interdisciplinary Geriatric Education Center until 1992, when he accepted an endowed Chair of Geriatric Medicine at the University of Louisville. One year later, for family reasons, he returned to Oklahoma to begin a new career in research, including completion of the requirements for a Masters Degree in Public Health (Biostatistics), and the opportunity, because of a Title VII grant, to start a practice-based research network. Now with more than 300 members in 96 practices throughout the state, The Oklahoma Physicians Resource/ Research Network (OKPRN) is recognized as one of the most successful and influential regional PBRNs in the country. Dr Mold is an author of approximately 100 peer-reviewed scientific papers, monographs, and book chapters.
Sunday, April 29
10:00-11:30 am
“Why National Health Insurance Is the Obvious Prescription”
Claudia Fegan, MD, Fantus Health Center, Chicago
There is broad consensus the present system for health care in the United States is not working, as evidenced by more than 46 million uninsured. Yet the United States spends close to $2 trillion a year on health care; at nearly $6,000 per capita we spend more than any other country in the world. With a work force of almost 10 million people, including 600,000 physicians and more than 2 million nurses, you would think we have the resources to provide care for those who need it.
The problem with American health care is our inability to see beyond employment-based financing. It stagnates the economy as people keep unwanted jobs to maintain insurance, while health resources hemorrhage into the private-insurance bureaucracy.
We spend enough on health care and we have enough resources, the obvious solution is a single-payer form of financing for national health insurance. The American people are not the barrier to this solution; they understand the problem. It is the powerful lobbyists representing the insurance, pharmaceutical, and medical industry who stand in the way. It is the responsibility of health care providers to speak out for solutions we know are right. We too represent a powerful force in this struggle.
Claudia Fegan, MD, is a board-certified internist who trained at Michael Reese Hospital in Chicago. She subsequently served as medical director for Michael Reese after becoming board certified in quality assurance, risk management, and utilization review. Dr Fegan left her successful private practice of 15 years to join the Cook County Bureau of Health Services in 2000. She currently serves as medical director for Fantus Health Center, a huge primary care clinic that serves more than 2,000 patients a day, part of the Ambulatory and Community Health Network of the Bureau. Dr Fegan is a past-president of Physicians for a National Health Program. She speaks extensively in this country and Canada about the impact of corporatization on the delivery of health care and the need for universal health care. She collaborated with Canadians Hugh and Pat Armstrong on Universal Healthcare: What the United States Can Learn from the Canadian Experience.