THOUGHTS AND THEMES FROM THE 2016 ADFM WINTER MEETING

Are we Luddites? How can we “recalibrate”? What is a more pressing need in our Departments than producing outstanding family doctors? How can we bring joy back to clinical practice? These questions are a few among many that stimulated our thinking during ADFM’s 2016 Annual Winter meeting.

A provocative plenary delivered by Steven Wartman, MD, PhD, CEO, and President of the Association of Academic Health Centers, prompted us to consider how much our adherence to the past may be our biggest hindrance to being relevant to the present and future.¹ Dr. Wartman noted that with companies and entrepreneurs producing health care solutions which go beyond and/or bypass the medical profession, our “guild” is rapidly eroding. Using a clip from the clever video “Humans Need Not Apply,”² featuring 2 horses discussing how the automobile would never supersede horse-drawn means of transportation, Dr. Wartman left us wondering whether we, like these horses, are Luddites—those who resist changes in technology—in our practices and Departments.

Dr. Wartman presented us with a challenge—how can generalists recalibrate for 21st Century medicine?—and an assertion—Academic Health Centers are the only institutions with the unique ability to align academics with patient care to achieve the “virtuous cycle” of education, research, and improved care and outcomes for our patients. Larry Green, MD, the Epperson Zorn Chair for Innovation in Family Medicine and Primary Care at the University of Colorado, furthered the dialogue initiated by Dr. Wartman with a focus on defining the promise of the personal physician.³ He challenged the group by asking whether producing outstanding personal physicians is a priority for our Departments of Family Medicine and, if not, what is more important?

How departments can help in the move from volume- to value-based care within our states was a highly energizing session moderated by Duke Department of Community and Family Medicine Chair J. Lloyd Michener, MD, with 2 outstanding young leaders in our discipline, Lauren Hughes, MD, MPH and Kate Neuhausen, MD, MPH, speaking from their experiences as contributors to health policy in Pennsylvania and Virginia, respectively.⁴ What we do locally and regionally is becoming more important as Departments of Family Medicine seek to exert influence in the current world of fast-paced changes in care delivery. Therefore, we set aside time for informal discussions among those from the same state or region for the first time. After the meeting, Dr. Neuhausen shared resources to help Family Medicine Departments implement 3 major recommendations that are priorities in most states: integrating addiction treatment including medication-assisted treatment (suboxone/buprenorphine and counseling) for opioid addiction into family medicine residency clinics and curricula; promoting integrated behavioral health and primary care by training family doctors to work with behavioral health providers and testing new payment models; and addressing the needs of high-cost populations by training family doctors to work in interprofessional teams to address the complex needs of “super-utilizers” and testing new payment models.

As part of a larger focus on resilience in Departments of Family Medicine, which included a panel of chairs sharing best practices from their own departments, Christine Sinsky, MD left lasting impressions with her presentation on the ways changes in practice can actually help keep family physicians working and happy in their jobs.⁵ Stimulated by what more we can be doing in ADFM, our leadership has since been asked to consider how we can collectively take the challenges Dr. Sinsky presented and work together to improve our academic practices.

Several sessions continued our tradition of learning from each other. We had a practical panel on developing research infrastructure followed by discussion groups for those with all different levels of research development, noting that a common denominator to successful research in any department is having a culture of inquiry. The final session of the meeting focused on a variety of innovative compensation plans that exist in our departments. One of the themes which these sessions illustrated is that, despite the many challenges our Departments face, the solutions and/or effective ways to address the challenges are often within the room at our Annual Winter meeting.

• © 2016 Annals of Family Medicine, Inc.