President's Letter
A busy start to a busy year
By Tricia Elliott, MD
Greetings colleagues. Regardless of what you think about the first several weeks of 2017, you certainly can’t say they’ve been boring. With the inauguration of a new president and the installation of his administration, the uncertain future for the Affordable Care Act, and the start of the 85th Texas Legislature, we have a lot of big issues to keep up with.
As it turns out, “repealing and replacing Obamacare” is much easier said than done and anyone who professes to know how the president and Congress will proceed most likely doesn’t. AAFP continues to be an influential resource to policy makers in Washington D.C. In letters to President Trump and to the leadership of the House and the Senate, AAFP has defined its priorities: health care for all, delivery system and payment reform, health care affordability, a national health care workforce strategy that promotes the value of primary care, and the promotion of prevention and wellness.
“The AAFP and its more than 124,900 family physicians and medical student members are eager to partner with you and your Administration to identify and implement policies that improve people’s lives through an accessible, high-quality, efficient, and diverse health care system,” AAFP President John Meigs, Jr., MD, wrote to then President-elect Trump after the election. “I and our members stand ready to do the important and hard work necessary to achieve these goals.”
Our Academy has also been pushing to reduce the administrative burdens family physicians face every day, like prior authorizations, documentation guidelines for E/M services, and translation service costs. These and other regulatory hurdles drive up operating costs and erode the thin margins most family doctors depend on to keep their doors open. In a recent “In the Trenches” blog post, AAFP Senior Vice President of Advocacy, Practice Advancement, and Policy, Shawn Martin wrote that reducing these regulatory and administrative hassles is a priority for the Academy.
“The AAFP is actively advancing reforms with both public and private payers, but we also are advocating for reductions in burdens associated with the licensure and certification processes -- both of which have grown at a healthy pace during the past decade,” he wrote.
Meanwhile back at the ranch, the Texas Legislature is in full swing and your Academy is on the scene, promoting policies that help family physicians continue to provide their patients excellent care. Texas faces a budget shortfall of about $6 billion for the next two years, which means lawmakers will be scrutinizing programs for possible cuts as they craft the state budget for 2018 and 2019.
TAFP will work to protect policy gains we’ve made over the past few sessions, like funding for family medicine residency programs, support for the Texas Family Medicine Preceptorship Program, and the Physician Education Loan Repayment Program. We’re also advocating for legislation that would help physicians offer their patients telemedicine services and receive payment for those services.
And of course the Academy intends to protect the collaborative practice, team-based reforms the Legislature passed in 2013 when physicians, nurse practitioners, and physician assistants agreed to streamline the state’s scope-of-practice laws. Once again, nurse practitioner organizations have come to the Capitol seeking the authority to diagnose and treat patients independently under the supervision of only the Texas Board of Nursing. We believe this further fragments our already fractured health care delivery system without any evidence that such a move would increase access to care for patients in underserved communities.
There are several ways you can help advocate for your specialty, your colleagues, and your patients, and you can find a handy list at www.tafp.org/advocacy/get-involved. Perhaps the most interesting way is to serve as Physician of the Day. Since 1971, TAFP has provided a family physician in the Capitol First Aid Clinic to treat anyone on the grounds each day the Legislature has been in session. As the Physician of the Day, you are introduced in both the Senate and the House of Representatives and your name becomes a permanent part of the official legislative record. You have an opportunity to meet your representatives and spend the day doing what you do best in one of the state’s most historic settings.
I served as Physician of the Day on the first day of this session and I brought along a friend. Mercedes Giles, MD, a second-year family medicine resident at UTMB Galveston joined me for the day and it was thrilling to be there with her as we showed our elected officials what two family physicians really look like! There are plenty of spots still available if you’d like to participate. Just go to the Advocacy section of TAFP.org and click on the Physician of the Day link.
TAFP and AAFP serve as our voice, speaking for family medicine in the State Capitol and on the Hill. We have a strong team of advocates with great relationships across state and federal agencies and with our legislators. In these times of great change, our Academy continues to make strides in support of our patients and our practices. But we couldn’t do it without you, so go to TAFP.org and explore how you can get involved.