Greetings, colleagues. Thank you for the opportunity to serve our organization as TAFP President. It is truly an honor. I would like to introduce myself and reflect on what it means to me to step into this role.
If you have read or listened to any of the work of Simon Sinek, you’ll know that he believes that starting with “why” is the key to inspiring action, and that “why” is perhaps more important than “what” or “how.”
My “why” for being a family doctor, and what led me down the path of leadership with TAFP, is to transform health care, and I strongly believe that we can’t transform health care without strengthening primary care.
In all candor, I’ll share that I didn’t always know family medicine is where I would land. As an undergrad, I had the chance to take classes in health care policy, medical ethics, and medical sociology. This was at a time when the Institute of Medicine published “To Err Is Human,” which posited our nation’s poor health care outcomes are driven by good people working in bad systems.
While I was in medical school, Barbara Starfield and her colleagues had just published their pivotal piece, “Contribution of Primary Care to Health Systems and Health” in the Millbank quarterly. They described how 1) health is better in areas with more primary care physicians, and that people who receive care from primary care physicians are healthier; 2) systems in which primary care physicians are the usual source of care are associated with decreased racial and socioeconomic disparities, and decreased deaths; and 3) better health outcomes are found in communities that distribute resources equitably and have professional incomes for primary care physicians that are comparable to specialists.
As I went on to work in student-run free clinics and our safety-net system, I saw patients without access to primary care coming in with treatable diseases in advanced stages, at young ages. I saw the inequity in the system, and the potential for change.
So, it turns out that primary care was the perfect place for me to work toward my “why.” The work we do matters to our patients, but the existence of our specialty matters to the system and offers us the opportunity to transform health care. It didn't hurt that being a family doc is just pretty darn cool.
But primary care was also the perfect place for my personality and where I would enjoy the “what” in my career.
“As much as we need organizations like TAFP to support our advocacy, its real value is in building community — our family medicine community.”
I think curiosity is probably a trait many of us share as family doctors. We are always learning, and there are so many paths we can take. I’ve had the chance to pursue business education, take on roles teaching medical students and residents, perform research and scholarly activities, and practice a broad scope of family medicine, including delivering babies, seeing patients in intensive care units, skilled-nursing facilities, and long-term acute care centers.
I’ve experienced the joy of patients following me across practices, even when it meant driving clear across Houston. I now have the chance to work as a primary care physician and medical director at One Medical, part of the Amazon Health Services family. I get to grow and coach clinical leaders across our practices in the Midwest and Texas. One of my favorite Amazon leadership principles is “learn and be curious.” It is the idea that leaders are never done learning and always seek to improve themselves. They are curious about new possibilities and act to explore them. I like to ask questions and am a problem solver and a strategic thinker.
Being inherently curious, I had to come to grips with the idea that you can do it all, but you can’t do it all at once. (Unless you are a rural family doc, and then you are truly one of those superheroes doing it all at once). For me, I knew that I also had to be part of something bigger than just my day job. And I also knew that I needed to surround myself with people that are doing the things that I might no longer do regularly. This is where TAFP comes in.
If you can’t do it all at once, how do you actually go about transforming health care? Early on, I saw the power of organized medicine to amplify this message and began to get involved. What I found in TAFP was not just an organization that could support policy change, but an organization with the people that would keep me motivated and driven along the way. Tricia Elliott, MD, supported my involvement as my residency program director. Clare Hawkins, MD, believed in me and encouraged me to take on a faculty role after residency. Many others have directed me to new opportunities. If you are a leader reading this, don’t underestimate the power you have to sponsor a resident or medical student in finding their next opportunity. If you ever get an email from TAFP asking you to apply for something, please respond to the call. We can connect fellow family doctors to positions of power in other organizations, and throughout the health care system.
TAFP has become my professional home. It is the constant as I have transitioned jobs. It is a place for networking and camaraderie. I look forward to each meeting, when I get to see old friends and make new ones. I get ideas to bring back to my practice — through “official” CME as well as the “unofficial” side conversations over lunch or a drink. I hear what others are doing in their practices. I continue to see the variety of family medicine more than I could ever see just in my own practice. We all maintain our individual circles, whether it be from medical school, residency, or our own communities, and it is tempting to think we can insulate ourselves from other viewpoints. The diversity of the TAFP membership is our strength. TAFP is a place where we can have difficult conversations and unite in our shared belief in the power of primary care, and how we can make this system better for our patients and ourselves. As much as we need organizations like TAFP to support our advocacy, its real value is in building community — our family medicine community. I believe in the power of TAFP to create the community needed for a strong primary care workforce.
My “why” may be different than yours. The beauty of TAFP is that it likely can also help you further your why as a family doctor, whatever that might be. Our power comes from being together. As Margaret Mead said, “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.” Nearly 20 years after Barbara Starfield’s work came out, our challenges are still here. More people need access to primary care. We need to reduce the inequity in the system by giving people access to primary care. The payment divide between primary care and specialties must change.
As I set forth into this year as TAFP President, I want to work to strengthen the leadership training we provide to family physicians and help get them into positions of power throughout the health care system, and I want to ensure we make TAFP feel like the professional home for all family doctors in Texas, supporting their “why” for being in primary care. I invite you to join me.