ORLANDO -- The chief executive at the American Academy of Family Physicians scolded FPs for being too eager to refer patients to subspecialists and for their "sorry performance" in providing after-hours and weekend access for patients.
But , AAFP executive vice president and CEO, also exhorted the assembled members of the Congress of Delegates to "firmly defend healthcare as a fundamental human right." Henley choked back tears as he read that statement, and the delegates responded with a prolonged standing ovation.
This was the second time that Henley was brought to tears discussing healthcare access before the AAFP. In September of 1994, when Henley was president of the AAFP, the was officially declared dead by Congress. A few days later, the AAFP convened its meeting in Boston and Henley broke down as he shared the Academy's failed efforts to support that legislation.
And from the delegates' reaction, it was clear that Henley's unabashed passion struck a nerve with them.
Taking a tougher tack, Henley said, "Two international Commonwealth Fund surveys place the U.S. at the bottom of 'after hours' availability. And only 29% of U.S. physicians indicated their practice ensured a plan for after hours contact or care. ..." Moreover, he said, physicians generally consider "access" to be an automated referral to an emergency room.
He reminded the delegates that the basic tenets of primary care are summarized by four Cs -- first contact, continuity, comprehensiveness, and care coordination. He cautioned about the "rapid rise in the number of referrals out of primary care to subspecialists," which he called an "alarming trend."
On the flip side, Henley applauded the embrace of the medical home model among FPs: just over 45% of AAFP members now work in designated medical home models, which is an increase of 10 percentage points in the past year.
Many physicians are concerned about the conversion to MACRA (Medicare Access and CHIP Reauthorization Act), but he pointed out that the AAFP and "the entire house of medicine lobbied for a solution to SGR and we had 2 years to study the legislation before its final passage. Absent this legislation, remaining in an SGR world would have been worse than moving forward in a MACRA world."
Moreover, Henley applauded the recent announcement by the Centers for Medicare and Medicaid Services offering four options for doctors to ease into MACRA.
The AAFP delegates will spend the next several days debating a number of recommended policy changes or new policies for the Academy. Those resolutions will become official AAFP positions if approved by the full Congress.