Family Medicine for America's Health

Meeting the Challenges of Family Medicine Practice

Jason E. Marker, MD, MPA; Glen R. Stream, MD, MBI; Laurie Scudder, DNP, NP


August 31, 2017

Editorial Collaboration

Medscape &

Laurie Scudder, DNP, NP: Hello and welcome. I'm Laurie Scudder, the editor of Medscape Family Medicine. I'm here in Kansas City at the American Academy of Family Physicians (AAFP) National Conference of Family Medicine Residents and Medical Students. I'm delighted to be joined by Drs Jason Marker and Glen Stream. Gentlemen, could you introduce yourselves?

Glen R. Stream, MD, MBI: Hello. I'm Glen Stream. I'm a family physician practicing in southern California, and I'm currently president and board chair of Family Medicine for America's Health.

Jason E. Marker, MD, MPA: Hello. My name is Dr Jason Marker. I'm a practicing physician from northern Indiana, and I serve as the Practice Transformation Core Team leader for Family Medicine for America's Health.

What Is Family Medicine for America's Health?

Dr Scudder: Thank you. Let's start with this question: What is Family Medicine for America's Health? Could you tell us a little bit about this organization, Dr Stream?

Dr Stream: Family Medicine for America's Health is a 5-year collaborative project of eight national family medicine organizations. We have just begun our fourth year. There are a couple of components to our project. A large public—and key stakeholder-facing communication effort, called Health is Primary, raises awareness about the importance of primary care to the health of [individuals], their families, and their communities. And we have a strategic effort for how family medicine can step up and really be part of the solution to many of the challenges facing our healthcare system.

We are focused around the "quadruple aim,"[1] which is to improve people's experience in the quality and safety of their care, to improve the health of the population of the country, to tackle the really crippling healthcare cost issues, and, very importantly, to deal with the professional satisfaction of physicians and others who work in the healthcare team.

Support for the Practicing Physician

Dr Scudder: How does Family Medicine for America's Health support you in your practice, Dr Marker? How does it support practice transformation and your professional satisfaction?

Dr Marker: The Practice Transformation Core Team was really excited to be offered the opportunity to do some novel, out-of-the-box thinking about what family medicine, as a specialty, needs to do to better support better patient care. The systems of care that we work within today are very cumbersome, add a lot of administrative burden, fuel the stress loads of physicians, and lead to physician burnout. We knew that we needed to look at the bright spots around the country where novel practice transformations were already happening, and begin to think about how those could be brought to bear in all corners of the country.

We are doing a wide-ranging bit of research to find measures that really matter to physicians and other stakeholders, like employers and insurance companies. We are doing work to find out how we can better provide care for patients in office settings and also in asynchronous settings, like through a cell phone. We are trying to come up with solutions that could be applicable in a wide range of venues and to different practices around the country.

Dr Scudder: That is a lot to do. How does one get started? My experience is that family physicians tend to be kind of nice. Can that get in the way of being able to take the bull by the horns and transform one's practice? How do you get started?

Getting Around 'Nice'

Dr Stream: The concept of "family medicine nice" is one that I coined at the kick-off of our project because family physicians tend to be nice people and tend to not want to blow their own horn. The idea of greater investment in primary care, greater respect for primary care, and a more key role in the healthcare system is something that they have trouble advocating for because they see it as self-serving. Yet, it's not self-serving to do what is in the best interest of patients in our country. We have to get over "nice," and we have to be a little more aggressive in seeking the kind of practice transformation changes and the investments, as far as primary care funding, that make those things happen, because that is what is key to patients.

Dr Marker: This week, at the National Conference of Family Medicine Residents and Students, I have been teaching medical students and residents the idea that many of us are very humble and do not want to be like, "Look at me—I know how to do things better than some doctor who's been in practice for 40 years." Sometimes it's important to buddy up with somebody else who wants to do physician leadership like you are doing and just say, "Listen, I'll tell the world that you're doing a good job if you'll tell the world that I'm doing a good job." Sometimes it's a much less threatening way to be in a meeting, where you can say, "My friend Dr Stream does a really great job at this. You should look into stuff that he's doing." I know he would never say that, but I can say that. Finding buddies who can toot each other's horns is a way that you can begin and a simple way to get a bit beyond that "family medicine nice." There are lots of other starting points for anybody who wants to transform their practice. You can open any family medicine journal and find abundant ways to do that.

Transforming Family Medicine Practice

Dr Marker: At Family Medicine for America's Health, we are working toward putting together very tailored educational opportunities for you to find out just what you need to know, based on your current practice and payment demographics. We want to bring just those right educational tools to you so you do not spend a lot of time in areas that are not going to be really helpful for you. We want to provide an efficient streamline for docs so they can begin making even small transformations.

Dr Scudder: It's really helpful that folks do not have to reinvent the wheel, that they can tread in the footsteps of people who have been there before them. I'm very grateful to both of you for joining me here. Thank you for your time.

I hope we will see many of you at AAFP FMX (Family Medicine Experience) September 12-16 in San Antonio.

The AAFP FMX (Family Medicine Experience) will be held at the San Antonio Convention Center September 12-16, 2017. Registration and more information can be found here.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: