68th Congress of Delegates of the American Academy of Family Physicians
Report of the NHAFP Delegation to the NHAFP Board of Directors
The 68th Congress of Delegates of the American Academy of Family Physicians met in Denver, Colorado from September 27 to 30, 2015. Your New Hampshire delegation included delegates Paula Leonard-Schwartz, M.D. and Lou Kazal, Jr. M.D. as well as alternate delegates Mary Cullen, D.O. and Polina Sayess, M.D. In addition, our team included Hilary Alvarez, M.D. as an observer and Amy Schneider, M.D., former delegate and member of the AAFP Commission on Quality and Practice as a wise advisor. We submit the following report for your review and approval prior to distribution to the general membership of the NHAFP.
As usual, your delegation hit the ground running. After several orientation sessions on Sunday, your delegates and alternates met with the Academy leaders running for national office in a Meet the Candidates Session. At the Annual Town Hall Meeting on Sunday evening, we heard from the leadership of the AAFP about several issues of importance to our members.
President Robert Wergin, M.D. and CEO/Executive VP Douglas Henley, M.D. gave us an overview of MACRA, the Medicare Access and CHIP Reauthorization Act recently passed by Congress. We all know this as the law which has eliminated the SGR (after over 10 years of lobbying by the AAFP and other physician groups) and has continued federal funding for state Children’s Health Insurance Programs. Other important features of the law include requiring physicians participating in Medicare to choose between two new models/pathways for payment in the transition from the fee-for-service system to value-based payment systems. The two new value-based models are APM (Alternative Payment Model) and MIPS (merit-based incentive payment system), both of which are based on paying for value rather than paying for volume. We were also told that the AAFP will be providing educational resources directly to state chapters and also on the AAFP website to help members understand these new models.
President Elect Wanda Filer, M.D. discussed workforce issues, including the response to the new AAFP policy “Aligning Resources, Increasing Accountability and Delivering a Primary Care Workforce for America” approved by the 2014 Congress of Delegates. As you might recall, this policy calls for major reform of Graduate Medical Education funding to restrict federal dollars to first certificate residency training programs and to mandate an increase in the number of primary care residency positions to meet the workforce needs. As expected, there has been some pushback from the AAMC, AHA, and some specialty societies, all of which would lose funds but there has been some support on Capitol Hill, where there have also been calls from 25 members of Congress who have asked the OMB to investigate current GME funding. Dr. Filer also highlighted the difference between student interest in family medicine and student choice of family medicine. She noted that, although medical student interest in family medicine is at an all-time high (30,000 students are members of the AAFP, roughly one out of every 4 medical students), student choice of family medicine as a career remains low. Board Chair Reid Blackwelder, M.D. discussed the AAFP’s work on several regulatory issues. Noting that information technology issues remain the #1 concern of AAFP members, the AAFP is working to shift the responsibility for EHR interoperability (and the associated fines for lack thereof) from physicians to HER vendors. The AAFP was successful in getting the reporting period for meaningful use reduced from 365 days to 90 days. Finally, the AAFP has provided resources on the AAFP website for members to use for ICD-10 implementation.
Following these updates, Academy leaders fielded questions from the audience about multiple other topics, including state Medicaid expansion, practice transformation, PCMH recognition, CCM, hospital-owned physician practices, ACO’s, and family physicians’ narrowing scope of practice.
The Congress of Delegates officially convened on Monday morning, with words of welcome and encouragement from Speaker John Meigs Jr, M.D. As is the custom, we also heard addresses from AAFP leaders, including President Robert Wergin, M.D.; President-Elect Wanda Filer, M.D.; Board Chair Reid Blackwelder, M.D.; CEO/executive VP Douglas E. Henley, M.D.; and Speaker John Meigs Jr, M.D.
The remainder of Monday was devoted to the five reference committees: Advocacy, Organization and Finance, Education, Practice Enhancement, and Health of the Public and Science. New Hampshire’s own Lou Kazal, M.D. served as chairman of the Reference Committee on Health of the Public and Science. Other members of your New Hampshire team attended each of the committees and testified about issues important to family physicians in New Hampshire.
On Tuesday, the Congress received greetings from leaders of other medical organizations, including:
Ruth Wilson, M.D., from the World Organization of Family Doctors (WONCA)
Garey Mazowita, M.D., President of the College of Family Physicians of Canada (CFPC)
David Barbe, M.D., Past Board Chair of the American Medical Association (AMA)
James Kennedy, M.D., President of the American Board of Family Medicine (ABFM)
Jason Marker, M.D., President of Board of Trustees of the AAFP Foundation (AAFP-F)
Todd Shaffer, M.D., Chair of the Council of Academic Family Medicine (CAFM)
Kevin deRegnier, D.O., President of American College of Osteopathic Family Physicians (ACOFP)
Randy Wexler, M.D., Chairman of the FamMedPAC
Joseph Zebley, M.D., Chair of the AAFP delegation to the AMA.
We also heard remarks from Richard Bruno, M.D., Chair of the 2015 National Conference of
Family Medicine Residents and Christina Kelly, M.D. of Texas, Convener of 2015 National Conference of Constituency Leaders (NCCL) about the success of their respective conferences this year.
Several prestigious AAFP awards were also presented during the AAFP Congress of Delegates meeting in Denver, Colorado:
Thomas W. Johnson Award for Career Contributions to Family Medicine Education: Macaran Baird, M.D. of Minnesota.
Humanitarian Award: O. Michael Obiekwe, M.D. of Georgia, for his work around the world with Arms of Care International.
Public Health Award: Theodore Wymyslo, M.D. of Ohio.
Robert Graham Physician Executive Award: Nathan Newman, M.D. of Maryland.
Over the course of the meeting, your delegation had several opportunities to get to know all the candidates running for office in the AAFP. The Meet the Candidate Session on Sunday allowed us to speak one on one with candidates for President Elect and the Board of Directors and the Hospitality Suites on Monday evening allowed us to socialize. Candidates also delivered speeches to the Congress of Delegates and responded to audience questions in the Annual Candidate Forums. Ultimately, the Congress elected our new President-Elect, Speaker, Vice-Speaker, and members of the Board of Directors, as listed below:
President-Elect John Meigs, Jr, M.D. Alabama
Speaker Javette Orgain, M.D. Illinois
Vice-Speaker Alan Schwartzstein, M.D. Wisconsin
Director John Bender, M.D. Colorado
Director Gary Leroy, M.D. Ohio
Director Carl Olden, M.D. Washington
New Physician Director Marie-Elizabeth Ramas, M.D. California
Resident Director Richard Bruno, M.D. Maryland
Student Director Tiffany Ho Maryland
The majority of the work of the Congress of Delegates occurred in the Reference Committees and on the floor of the Congress, where we considered 59 resolutions from state chapters and other constituencies, 8 Board reports, and 3 Committee reports, most of which were contained in the 641 page handbook we reviewed before leaving for Denver! The following Reference Committee Reports summarize the actions of the Congress of Delegates on the resolutions, some of which were discussed at the September meeting of the NHAFP Board of Directors. Lou also served as chair of the Reference Committee on Health of the Public and Science. The complete reports of the Reference Committees can be found on the AAFP website:
The complete minutes of the 2015 Congress of Delegates can be found at:
The Congress of Delegates presents a unique opportunity to learn how policy is made within the AAFP, to meet the leaders of our Academy, to witness passion for our profession, and to get to know delegates from our state as well as from around our country. We wholeheartedly thank you for the generous gift it is to represent you all. If anyone is interested in learning about becoming a delegate or alternate delegate to next year’s Congress of Delegates, which will be held in Orlando, Florida, please talk to any of us in the delegation.
Paula Leonard-Schwartz, M.D.
Lou Kazal, Jr., M.D.
Mary Cullen, D.O.
Polina Sayess, M.D.
Amy Schneider, M.D.
Hilary Alvarez, M.D.
Please click on any of the following links to read the report.
Reference Committee on Health of the Public and Science
Reference Committee on Practice Enhancement
Reference Committee on Organization and Finance
Reference Committee on Education
Reference Committee on Advocacy