Health Is Primary

A campaign to help patients and physicians find a home in primary care

By Kate Alfano

Lloyd Van Winkle, MD, has practiced in Castroville, a small town outside of San Antonio, for 29 years. Day in and day out, same place, same office, same staff. Having cared for some of his patients for nearly three decades, he says his practice’s top priority is doing what’s best for them.

So when Van Winkle, also a board member for the American Academy of Family Physicians, heard about a new multi-year campaign launching at the 2014 AAFP Assembly in October, he did his research to make sure it would be beneficial to his patients and practice. The campaign – Health Is Primary – aims to rally patients, employers, policymakers, and other stakeholders across the country to recognize and support the value of family medicine and primary care in delivering on the Triple Aim of better health, better care, and lower costs, particularly through the patient-centered medical home.

His verdict? A thumbs-up.

“I’m a family doctor with real families, people I’ve taken care of forever, and if I can see value in this transition for my patients who I personally care about because they’re like my extended family, I think anyone else can see that that’s important.”

Health Is Primary is the communications program for Family Medicine for America’s Health, or FMAH – a coalition of eight national family medicine organizations including AAFP – that will drive a five-year strategic initiative to transform family medicine to meet the needs of a growing population of patients with increasing complexity of health issues. Seven of the eight organizations came together a decade ago for the Future of Family Medicine project, which launched a series of strategic efforts to renew the specialty.

Former AAFP President Glen Stream, MD, MBI, serves as FMAH board chair. He says physicians made significant progress to modernize and transform the specialty following the publication of the Future of Family Medicine report in 2004 “but there’s still much work to be done, particularly around people understanding the role of family medicine and primary care and changing the payment model to support that. That’s the alignment between the communications strategy and the strategic plan.”

After nearly a year of planning, FMAH identified its core strategies:

• Working to ensure broad access to sustained, primary care relationships;
• Accountability for increasing primary care value in terms of cost and quality;
• A commitment to helping reduce health care disparities;
• Moving to comprehensive payment and away from fee-for-service;
• Transformation of training;
• Technology to support effective care;
• Improving research underpinning primary care; and
• Actively engaging patients, policymakers, and payers to develop an understanding of the value of primary care.

“What we’re looking to do is to have patients and other stakeholders understand that foundational role of primary care and create a movement that moves our health care system to have that strong primary care foundation,” Stream says. “We think that a critical mission of our strategic effort is to improve health care, both the quality, patient safety and patient-centeredness of the care; improve health; and address the unsustainable, growing cost of health care in our country. We are just absolutely convinced that the Triple Aim cannot be accomplished without the strong primary care foundation that we’re advocating for.”

“The Future of Family Medicine was not quite as innovative in terms of being patient-centered the way the current system is,” Van Winkle says. “It was the first steps. We were learning as we went along. But the new system is a lot more focused on the patient being the center of the medical home.”

The FMAH board guides the strategic effort for the project. It comprises one representative from each partner organization plus at-large members representing four stakeholder categories: family physician in full-time practice, new physician leader, patient advocate, and AAFP state chapter executive.

Driving the work of FMAH are six tactic teams – payment, practice management, workforce, education, technology, and engagement – with broad representation from the primary care community. The core members of FMAH’s tactic teams met for the first time in December at the Society of Teachers of Family Medicine’s Conference on Practice Improvement in Tampa, Florida, to develop a five-year work plan for their strategy focus. Moving forward, each team will engage a broader group of up to 60 volunteers to help with various aspects of their plan.

TAFP member Christina Kelly, MD, leads the Workforce Core Team and says the kickoff meeting was productive and engaging.

“The FMAH Board has put a great deal of work into the strategic plan over the last several months, and it was exciting to see it be put into action,” Kelly says. “All of the tactic teams worked well within the team and in between tactic teams. The potential for collaboration is immense.”

“With the current state of our health care system, we have an opportunity to transform America’s health for the better,” she continues. “This is what is best for our patients. Advocating for our patients is something we do every day, and the core values of our specialty can be the catalyst for this transformation.”

Health Is Primary is designed to connect people to primary care and help them understand that 90 percent of health needs can be met in the primary care patient-centered medical home. The campaign will employ national advertising, workplace programs, and stakeholder outreach to raise awareness, and will travel to five cities in 2015 – Raleigh, Seattle, Chicago, Denver, and Detroit – to engage local stakeholders and showcase community-level interventions that are working to enhance and expand primary care and improve health.

The campaign will reach out to employers, disease groups, and health advocates to activate patients around major health issues to demonstrate how primary care can support them in preventing disease and promoting health. Health Is Primary launched the first quarterly consumer campaign in January, with a focus on nutrition and fitness, with chronic disease management, immunization, and smoking cessation following later in 2015.

Also in January, the campaign hosted a panel discussion at the Consumer Electronics Show in Las Vegas to share the family medicine perspective on consumer health technology, the start of the effort to engage with the technology community to help drive innovation and technologies that foster the connection between physicians and patients and improve patient care and patient health.

Stream says the biggest challenge to the campaign is the sheer size of the audience and the broad scope of the message. “We recognize that we can’t make this type of a change in the health care system on our own and are very much looking for partners to collaborate around areas of shared interests.”

“What we need the other stakeholders to understand – people in government, employers, health plans – is that our current system is broken in how it pays for primary care,” Stream says. “We’ll be engaging those groups around how to retool our health care system to be based on a stronger primary care foundation; changing the payment model is a linchpin piece of that project. … If the payment model changes to pay the medical home rather than just pay the doctor, then it will cover those services that we know can improve people’s prevention and wellness status, chronic illness, and care coordination.”

Jen Brull, MD, FMAH board member representing practicing physicians, often fields the question from colleagues about what this campaign will “do” to them. She says she hopes it won’t do anything to them but rather that it will do a lot “for” them.

“We want people to practice in a way that brings them joy and lets them do things the way they want to do things, and accomplish objectives that are important. I think the idea is we’re not looking to massively change or reform the way physicians practice. It’s all about how can we shape technology, legislation, payment, and pipeline to make your job easier so you can do a better job of taking care of patients.”

“I hope it means that whether I choose to be an independent, solo, primary care provider with a full-scope practice or a hospitalist in a huge urban center, if I’m a family physician I have a home for that style of practice and a way to be financially viable to do what I love,” Brull says. “That’s what I want it to be.”

Van Winkle agrees. “If a young person out there is looking for a personally fulfilling career decision in health care, I think that Health Is Primary will allow them to see what a family doctor’s life is like and what it’s like to develop a really incredibly fulfilling doctor-patient relationship experience. I think this project is going to create a healthier family medicine environment that will make it possible for young doctors-in-training to have a home for themselves.”

Ways to get involved

Talk to your patients: Tell your patients about Health Is Primary and how important primary care is to their health, and encourage them to spread the word. If you’re active on Twitter or Facebook, use the Twitter hashtag #MakeHealthPrimary and “like” the Health Is Primary Facebook page.

Attend a Health Is Primary event: The campaign will visit Raleigh, Seattle, Chicago, Denver, and Detroit in 2015. These visits will bring together national and local leaders to showcase community-level innovations in primary care that are leading to better health, better quality, and lower costs.

Share your story: The campaign is looking for examples of change that are underway around the country. Email your story to info@fmahealth.org.

Stay informed: The campaign sends out regular communications through Health is Primary and Family Medicine for America’s Health and they want to reach and hear from the family medicine community. If you haven’t done so already, sign up at www.HealthisPrimary.org to receive updates on the communications campaign, and at www.FMAHealth.org to receive updates and information on the strategic implementation effort.

Volunteer to be a support network member: The tactic teams are developing support networks of people with skill sets and experience specific to each of the six tactic areas to help accomplish the work that needs to be done. Anyone can express interest by sending an email to info@fmahealth.org. Be sure to include your background and interest areas.

Watch the first FMAH webinar: Family Medicine for America’s Health sponsored its first webinar in early November to update the family medicine community on their work and progress. Go to www.FMAHealth.org/articles-updates to watch the one-hour recorded presentation and others as they are available.

Donate: The eight family medicine organizations contributed significant financial resources to the project but continued funding is needed. Individuals and organizations can support the initiative by making a tax-deductible donation through the AAFP Foundation. Donate online at www.aafpfoundation.org/donatetoday and select “Family Medicine for America’s Health.”

Learn more: Read more at www.FMAHealth.org and www.HealthisPrimary.org.

Meet Family Medicine for America’s Health

FMAH sponsoring organizations
Association of Family Medicine Residency Directors
American Academy of Family Physicians Foundation
Society of Teachers of Family Medicine
North American Primary Care Research Group
American Board of Family Medicine
American Academy of Family Physicians
American College of Osteopathic Family Physicians
Association of Departments of Family Medicine

FMAH board members
Jen Brull, MD, Represents full-scope fulltime practicing family physicians
Thomas L. Campbell, MD, Association of Departments of Family Medicine
Jennifer DeVoe, MD, DPhil, North American Primary Care Research Group
Lauren S. Hughes, MD, MPH, Represents family physicians early in their career
Vincent D. Keenan, CAE, Represents AAFP chapter executives
Lauren Birchfield Kennedy, Patient Advocate, National Partnership for Women & Families
Jerry Kruse, MD, MSPH, Society of Teachers of Family Medicine
Paul A. Martin, DO, Secretary/Treasurer, American College of Osteopathic Family Physicians
Robert L. Phillips, Jr., MD, MSPH, American Board of Family Medicine
Glen Stream, MD, Chair, American Academy of Family Physicians
Michael Tuggy, MD, Vice Chair, Association of Family Medicine Residency Directors
Jane A. Weida, MD, AAFP Foundation

Kate Alfano is the former associate director of communications for the Texas Academy of Family Physicians. She now lives in Fort Collins, Colorado, and works as a freelance reporter.