Q&A: New AAFP president discusses the state of family medicine

Key takeaways:

• Some of the AAFP president’s top priorities are physician mental health, pay and administrative burden.
• Though the field faces many problems, he said there has never been a better time to be a family physician.

New American Academy of Family Physicians President Steven P. Furr, MD, FAAFP, is focused on increasing pay for family physicians to account for the comprehensive care they provide and draw more students to the field.

Furr, a family physician in Jackson, Alabama, was inaugurated as American Academy of Family Physicians (AAFP) president on Oct. 27, replacing Tochi Iroku-Malize, MD, MPH, MBA, FAAFP, who is now AAFP’s chair of the board of directors, as the head of the organization representing 129,600 physicians and medical students across the country.

In an interview with Healio, Furr discussed his plans and how AAFP will help address some of the challenges facing primary care.

Healio: What are your priorities for the AAFP, and what do you think the organization should be focused on right now?

Furr: Family physicians are the backbone and the foundation of the American health care system. The problem that we have right now? We don't have enough family physicians to meet the needs out there. As we have an aging population, we also have an aging workforce. Also, our medical students and residents who are coming out [of medical school] also are burdened with debt. So, we have a need to increase that workforce to meet the needs of our people. Also, the American people are sicker than they've ever been. They're living longer, but they also have a lot of chronic diseases that need to be taken care of.

As we go forward, the number of students we have going into family medicine is increasing, but it's still not enough, and we’ve got to make sure that we get more ... going into family medicine and choosing that as their specialty. But along with that, we also need to make sure we get them where we need them — so, particularly in rural areas and underserved inner city areas. There's a tremendous need there.

Healio: Aside from being inaugurated as AAFP president, what are some other highlights of your career?

Furr: My college of medicine has been in existence for 50 years, [and] they named 50 people of influence in those 50 years, so I was fortunate to be named one of those 50 people. s

I’ve been able to serve both at the national level and the state level. I’ve served both as president of the Medical Association of the State of Alabama and the Alabama Medical Directors Association, as well as on the Alabama State Board of Medical Examiners. And what I've learned is that family physicians are the best physician leaders because we really see the whole health care landscape. We understand what the other specialties are going through. And we understand all of our patients' needs. Family physicians are the best equipped leaders to lead medicine.

Healio: What is the AAFP doing to help physicians regarding some of the field's top concerns like mental health?

Furr: Yes, that’s a big concern for all of us. Physicians are under increasing amounts of stress — our whole society’s under stress, but the suicide rate is higher among physicians and other health care providers. We’ve worked hard on physician well-being, trying to make sure that physicians are taking care of themselves, and in fact, in my presidential address, one of the three things I focused on is physician well-being. Nobody else is going to take care of yourself if you don't take care of yourself first. And also, we've worked hard to get rid of the stigma around that; if you are having difficulty, making sure that you're able to reach out and get help.

There are many, many concerns. I think a lot of the stress that physicians deal with — they want to focus on taking care of patients. And there's so many things in medicine now that get in the way of us taking care of patients. We use some general terms for that — we say administrative burden and other things — but they make our days very busy, and we don't feel like we're spending as much time with a patient as we should and instead are doing other things that really don't make a difference in patient care.

A patient who might be controlling their diabetes and hypertension with their medications, suddenly their [insurance] plan changes and no longer covers that medicine. We have spent a lot of time changing their medication to try and help them out. ... There are a lot of administrative burdens. There are some things that seem like they would be good things, like quality measures. Physicians will be judged on those quality measures. The problem is that each health care plan we deal with has different quality measures. So, if you're dealing with 12 health plans, you might have 12 different groups of quality measures. You’ve got to know which health plan [a patient has] and what they're focusing on. We really need a universal standard. We want to get away from just looking at their numbers and get back to talking and sharing time with our patients rather than checking boxes and just spending time writing stuff in the electronic health record. The AAFP is very focused on that, trying to reduce the administrative burden for physicians so they can spend more time doing what they need to take care of their patients.

Healio: What are some goals that you hope to achieve in this position?

Furr: Unfortunately, like most everything in life, it does come down to money. If we're really going to attract more students and residents into family medicine, we have to get the reimbursement for family medicine. A code we're working on now is called G2211, which would actually, in some ways, help us get paid more. It's an add-on code for doing the comprehensive, total patient care that we deliver.

We have to get appropriate reimbursement. Medical students and residents are coming out with an enormous amount of debt — some of them well over $200,000, $250,000. And even though you can say “they're going to make good money over their career,” that's a huge amount of debt. Some of those students and residents choose to go into other specialties that pay more than family physicians to help alleviate that burden. So, we're losing some of those. If we can increase our reimbursement for family medicine, hopefully we will get some of those students and residents to choose family medicine.

I think the great thing is that we've been talking about these issues and people realize that family medicine and primary care is in need, and they are starting to listen to us both at the state level and at the federal level. Some of these issues include decreasing administrative burden, ensuring family physicians are adequately paid and have access to the tools and resources they need and making sure we have a robust family medicine workforce that is trained in areas where patients need them the most, including in rural and underserved areas. People are starting to listen and realize this is a critical need that we need moving forward.

We're getting health care deserts, where there's nobody to take care of patients. And we’ve got to make sure that those deserts don't expand so we're able to deliver health care where it's needed.

Healio: Is there anything else you would like to add?

Furr: I think it's really easy to focus on the negatives. But at the same time, I would say it's never been a better time to be a family physician because we have better vaccines than we've ever had. We’ve got new and better vaccines and therapeutics to prevent diseases such as respiratory syncytial virus. There are better drugs than ever to control diabetes and hypertension. We’ve got better drugs than we've ever had to combat obesity. So, it's a great time to practice medicine.

We can do more for our patients than we ever could, we just need to make sure we get the barriers out of the way — such as administrative burden and other things that keep us from taking care of our patients — but I don't want it to get lost that this is a great time to be a family physician.

Reference:

• AAFP. https://www.aafp.org/about/meet-our-leadership/board/furr.html. Accessed Oct. 24, 2023.