Get your guide to restoring the American dream
By Tom Banning
Dave Chase, a friend of mine who was a longtime contributor to Forbes among other magazines, spent the better part of the last three years traveling the country documenting the multitude of failures of our health care system (pricing, contracting, lack of transparency, conflicts of interest), but more importantly identifying simple and tested solutions employers and some local governments have utilized to decrease their total health care spend.
His efforts have culminated in a compelling, must-read book, “The CEO’s Guide to Restoring the American Dream.” We’ve partnered with Dave on several physician–employer community events and in return, he has thoughtfully offered members and friends of TAFP a complimentary digital copy of his book. Below, I’ve provided a link to his TED Talk, “How Health Care Stole the American Dream,” as well as a link you can use to download a copy of “The CEO’s Guide to Restoring the American Dream.”more
What kind of system do we want?
By Tricia Elliott, MD
In his seminal book “The Signal and the Noise,” renowned statistician, Nate Silver, examines the world of prediction, investigating how we can distinguish the truth — the signal— from the noise, which he describes as a universe of ever-increasing information, relatively little of which is useful.
Any candid observer of the now nearly decade-long effort to reform our health care system will readily admit that the health care debate we’ve been engaged in has generated a lot of noise and useless information for political gain. Our elected leaders, on both sides of the aisle, have been busy creating this noise and are now trapped in a political vise of their own making. They’ve sadly left the public with a binary choice of whose health care solution is better, that of the Republicans or the Democrats.more
The 24-hour primary care clinic
A model whose time has come
J. Stefan Walker, MD
Luke Fildes’ portrait “the doctor” epitomizes the primary care physician that our younger selves aspired to become.That kind of doctor-owned practice is now slipping away as quickly as the business model supporting it. Where $300,000 per year is the new benchmark for employed primary care positions, the prospect of starting or joining a private practice only to tread water in a sea of acronyms (MACRA, HIPAA, HMO, ACO, etc.) for margins that barely cover overhead no longer makes sense to most family physicians. No wonder that in 2016, for the first time, less than half of American doctors partly or fully own their practices.
As the care of inpatients became a separate field, primary care was mostly sidelined into a 9 to 5 office job in a role now shared with mid-level practitioners, retail clinics, and telemedicine services. Unlike many other specialists still seeing patients during nights and weekends, primary care is now conspicuously absent in that important space, further putting pressure on family physicians to justify the level of reimbursement that can support independent practices. Now a rarity, small primary care practices — even those now thriving — risk succumbing to this tide of obsolescence, not unlike local department stores and indoor shopping malls.more
TAFP governance profile: Section on Maternity Care and Rural Physicians
By Jean Klewitz
Do you have a specific interest in rural medicine? Want to learn how to face challenges as a rural physician or a maternity care provider? This active section can help you work through those challenges. The integration of full-spectrum maternity care in rural family practices is their focus and they seek to create more opportunities for growth in these remote communities.
The section also works with AAFP’s Rural Health Member Interest Group and AAFP’s Reproductive Health Care Member Interest Group to provide opportunities for rural medicine and maternity care education, training, support, interest, and involvement for physicians, students, and residents.more