Q&A: AAFP’s new president wants a ‘primary care-centered health system’
New American Academy of Family Physicians President Sterling Ransone, Jr., MD, FAAFP, is focused on making primary care physicians more accessible and paying them “what they're worth.”
Ransone, who is a third-generation family physician, told Healio Primary Care in an interview that his professional and personal experiences in rural Virginia make him qualified to oversee those efforts.
“I understand the plight of small practices and the difficulty they've had in keeping their doors open or staying in business during the pandemic. I understand a lot of what they have to go through in order to have their practice remain viable,” he said. “Rural physicians do everything. The scope of family medicine is so broad, we sometimes follow our patients from cradle to grave.”
In the interview, Ransone outlined his strategy for change and discussed some of the highlights of his career.
Healio Primary Care: What are your priorities for the AAFP?
Ransone: There are lots of things that the AAFP is interested in, but I’d like to boil it down to three things.
First, I’d like to focus on establishing an outpatient health care system focused on having a primary care-centered health system where there is a family physician [available] for every person in every community. Our current health care system is set up in such a way that primary care physicians, especially family physicians, have been disincentivized — we’re not paid what we're worth to the health care community. If we can change the focus of our health care system to one that is primary care-centered, we can save lives and have a healthier population. The version I am proposing is based on the theme of team-based care; however, our version recognizes that physician assistants and nurse practitioners are trained differently from family and primary care physicians. The version I am proposing will also allow us to be paid for our value, instead of the antiquated fee for service system.
The second thing we really need to work on over the next several years is teaching our members to understand, adapt and leverage technology and electronic innovation. We'd like to do this to truly reduce the administrative burden so we can return our time and focus to patient care. As primary care physicians, we still spend a majority of our time doing computer work and not the face-to-face time with our patients that we were trained in and get most of our joy from. The use of telemedicine services is just one part of this.
The third thing is setting up a payment structure that pays family and primary care physicians what they're worth. We save a lot of money for the health care system. And we know that when a primary care physician goes into a community that lives are saved. Unfortunately, our system is not set up in a manner which reimburses us for that benefit. If we can have better payment for our services, and if we're recognized for what we do, we'll get more people interested in family medicine and save [more] lives.
Healio Primary Care: How is AAFP helping physicians impacted by the pandemic?
Ransone: There are four main things that the AAFP has done to help our members with the pandemic.
The first is education. We've tried to have our website contain the most current, accurate information so we can be a source for people to go to. We've had multiple town halls over the past year and a half and are going to continue doing that. We're also in the process of changing some of our CME requirements to help our members more readily attain their CME credits.
No. 2 is payment. We're actively advocating for reimbursement for telemedicine services. There is also the G-2211 code, which is a primary care add-on code that we'll be able to start billing for in 2023, that should help raise the reimbursement for all family physicians and primary care physicians.
The third is safety. At the beginning of the pandemic, a lot of us — especially those of us in the small practices — had difficulty getting personal protective equipment for our practices. The AAFP partnered with some distributors to receive good quality PPE at reduced prices. Over the next several years, the academy will be advocating to make sure that national stockpiles of PPE are up-to-date and rotated, so that if there is ever another pandemic, we will have adequate safety equipment for all our members.
The last way the AAFP has helped is by looking out for the health of its members. This has been an incredibly stressful year-and-a-half for all physicians — especially primary care and family physicians — as we have combatted depression, fatigue and burnout. I’d like to say you're not alone. Together, we can move mountains, and together we can help get through this pandemic help our patients and save lives.
Healio Primary Care: What should family physicians and PCPs be telling their patients about COVID-19?
Ransone: When I gave my speech when I was installed as president, a big part of it was about family physicians and combating misinformation. Four years ago, when I first ran for the AAFP board, there were a lot of mistruths out there regarding the measles, mumps and rubella vaccine causing autism. Unfortunately, the COVID-19 pandemic has only accelerated the amount of misinformation.
We need to be up front and tell the truth about vaccines to our patients. We need to be willing to spend the time to ask them questions about potential misunderstandings — from vaccines to masking to social distancing to air filtration, whatever it might be. A lot of times, if a physician just asks, patients will tell us what their concerns are, and we can combat some of the misinformation that they might have gleaned off the internet or social media.
There have been several studies that asked patients who they trust the most to give good medical advice. A patient's family doctor was at the top of each study’s list. Therefore, I would encourage all to use their pulpit to talk to their patients about truth and combat medical misinformation so that we can save lives.
Healio Primary Care: Aside from becoming president of AAFP, what are some other highlights of your career?
Ransone: About a decade ago, when we were debating the Affordable Care Act, I served on AAFP’s Commission on Governmental Advocacy. Being able to contribute to AAFP policy was wonderful and I really enjoyed it. I also got to testify before Congress as a member of that commission, and that was wonderful.
Another highlight was when, during my tenure as president of my state medical society, the Virginia General Assembly passed the Indoor Clean Air Act. Doing this in a tobacco state was incredibly difficult. I have also been vice chair of a group that preserved the medical malpractice cap in the Commonwealth of Virginia.
Other highlights have been the little things, including when a patient gives you a hug or thanks you for what you did. Those are the things that make the practice rewarding.