 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
|
|
Sixty
Years
of Caring And to think it all began with the end of a war. In the late 1930s, General Practitioners (GPs) accounted for 80
percent of all doctors--a number that soon began a rapid decline.
Too few training programs, a lack of role models in medical
schools, long hours coupled with low pay, and the lack of a
specialty board prompted the December 1940 issue of Medical
Economics to recommend the "formation, within the
American Medical Association, of a new, independent organization
dedicated exclusively to General Practitioners." Although the war delayed action, the issue resurfaced when
physicians returned to their practices. While in military service,
GPs--even those with extensive surgical experience--had noticed
they received a lower rank and pay than specialists. Upon
returning home in 1945, many GPs found they had lost the surgical
privileges they had before the war, and some hospitals denied them
admitting privileges as well. The Future
of GPs forged Although a record of who was really the first person to begin
the creation of the Academy does not exist, and many states have
their own versions--including GPs responded en masse, and by December 1945 the first planning
meeting for the General Practitioners Association took place in Other
GP groups formed In 1947, The ACPS objectives were: 1. Survival At the AMA convention in Although chartered in George Marchmont-Robinson, M.D. then organized the Illinois
Chapter of the Dr. Marchmont-Robinson was the first president of the Illinois
Academy of General Practice and served a two-year term. He was
committed to getting the Illinois Chapter off on the right foot,
and set out to bring in members from across the state. He
personally helped organize 37 Upon leaving the presidency, Dr. Marchmont-Robinson was elected
to the board of directors where he served two and one-half years
as its chairman. His leadership and steadfast belief in the
abilities of the GP began what is now a 50-year history of
organized family practitioners. One thing that rings clear in the history of family practice is
the more things change, the more they remain the same. Issues echo
generation after generation with the family physician's call to
arms "the care of the patient" superseding all else.
Whether it has been the fight for hospital privileges, educational
requirements, legislating medicine, cancer detection programs or
campaigns for immunizations family physicians have always been in
the lead protecting the welfare of the patient before all others. Issues
faced over the years: 40s and 50s time of call to action and
organization The issues of the day, beyond setting up the Academy and moving
ahead, were fee splitting, hospital privileges, compulsory health
insurance, encouraging members to meet the educational
requirements set up by the Academy, recruiting new members,
heading up chapter activity and working with the AMA and Illinois
State Medical Society (ISMS). The Academy also fought for special
emergency parking privileges for physicians. In 1951 the first central headquarters office was set-up under
the direction of Harry Marchmont Robinson, M.D., with Miss June
Rose as secretary at In May of 1951, the first issue of "The Family
Physician" was mailed. In 1957-58, family physicians
joined together to protest the United Mine Workers Welfare and
Retirement Fund Directive which completely left out general
practitioners services for payment. In February 1958, Dr. A.I.
Doktorsky, of One of the first programs developed by IAGP was the
"Medicine for Today" program held at medical school and
hospital sites around the state. First held in 1949, this
educational program has proved one of the most successful CME
programs ever and ran until the year 2005. The Illinois MFT
program was used as a prototype for programs across the country. Another unique gathering was the “Deans Dinners” held every
year, allowing medical school deans, MFT registrars and IAGP
leadership an opportunity to get together and discuss issues.
These dinners continued into the 1970s. 60s
a decade of camaraderie and change 1960 sparked the beginning of the Academy's scientific
exhibits, allowing family physicians to come to the annual meeting
and witness first-hand new scientific medical breakthroughs. The
60s also brought forward issues such as keeping patients alive by
using seatbelts, a "Medical Self-help Training Program"
designed to provide laymen rudimentary but effective knowledge of
how to care for their health needs in the event of a nuclear
attack, statewide preceptorships, and the importance of family
physician involvement in writing letters and making phone calls on
legislation. In order for the chapters to have more effective
communications with the state organization the Illinois Academy
Regional Chapter Officers Conference was established in June 1961.
Medicare becomes the law of the land in 1966. GP voices were heard loud and clear in support for and
demanding undergraduate training for general practice. John C. In December of 1961, during his keynote address to the 14th
Assembly, Norman Frank, M.D., IAFP president, called attention to
the fact "there are relatively fewer physicians entering general practice
than at any time in this nation's history." He proposed
the cure was to establish minimum, basic hospital privileges for
the GP and call upon medical schools to fulfill their
responsibility of training physicians to meet the nation's needs.
This problem continued through the years, until legislation was
called for in the 1990s to produce more family physicians and less
subspecialists. On The first family practice residency program in 70s
a decade of education and training 1970 marked the inauguration of general/family practice
training programs at "One of the most
difficult problems was recruiting and establishing a faculty to
teach the neophytes," says Lawrence Hirsch, M.D., IAFP
president 1976-77. "Although
there were many excellent family doctors throughout the state, the
fiscal implications of leaving one’s practice for an uncertain
future was a formidable obstacle. In addition, teaching is truly
an art and a science in itself. The board of directors authorized
a luncheon at the Annual Meeting for those in the field of
teaching family medicine, so as to coordinate efforts for the new
specialty." The Academy was also concerned about a fee-splitting bill that
passed in mid-1971, non-emergent cases entering the emergency
room, membership for osteopath physicians, supporting IMPAC
(Illinois Medical Political Action Committee) and carefully
considering options toward PSROs (Professional Standards Review
Organizations). 1976 marked the beginning of Student Family Practice Forums to interest more students in the specialty. In the fall of 1978, two residents Chuck Colodny, M.D. and Paul Nord, M.D. got together to create an organized student and resident group. "We
felt getting students and residents involved was important for the
future of family practice," explains Dr. Colodny. "We
sent delegates to the national conference every year, actively
participated on committees and voiced concerns and ideas at the
Congress. Much of the leadership we have now came out of that
early organization. Keeping the younger people involved is
imperative to keeping our organization growing and active." The late 1970s brought about concern for the lack of progress
at some medical schools for creating a department of family
practice, gas rationing, students and residents represented on
committees, and the appropriate role of physician extenders. In
1979, a resolution from 80s a
decade of re-structuring organization Entering the 1980s, the overall average of The mid-80s brought about wide-reaching organizational changes in the Academy, beginning with an Ad Hoc Committee created to suggest and help implement changes. The committee members were Lawrence L. Hirsch, M.D. (chairman), and Drs. Delbert Harris, Carolyn C. Lopez, William Tortoriello, and Eugene L. Vickery. Overall the committee submitted 41 recommendations (they can be found in Mar/Apr. 1984 issue of The Family Physician). A few things proposed included dramatically reducing committees and commissions by replacing them with three commissions: Public/Governmental Policy, Education, and Internal Affairs; study the Regional Chapter structure and function; MFT program cover not only what is new, but also help prepare members for ABFP recertification; pay attention to needs of younger members and their children when planning meetings, change timing of meetings and appointments. The 1980s also brought about many "firsts" for the
IAFP including: the creation of the office of Vice-Speaker; the
first osteopathic physician, Lawrence Plummer, D.O., was sworn-in
as IAFP president; followed a few years later by William Hulesch,
M.D., the first residency-trained physician to become president of
IAFP; 1984 marked the beginning of the Family Physician of the
Year award with Norman Frank, M.D. as the first recipient; and for
the first time, residents and students were allowed representation
on the Board, but could not vote. By the early 1990s they had won
the right to vote as well. In 1985 the AAFP Congress decided residency training would be required for all new active members beginning in 1989. Much discussion ensued over the years--and continues--that this created a "double-humped" membership curve in the Academy between the GPs and the FPs. "There
were a lot of tumultuous changes occurring simultaneously
throughout the 1980s," explains William Hulesch, M.D.,
IAFP president 1986-1987. "The
‘double humped camel’ was continually referred to as the
Academy leadership began changing with new leadership coming in at
a much more rapid pace. There was a very conscious decision to not
have a few physicians retain power through the years, but rather
to move aside and let others come up through the ranks. It was a
new way for the Academy to work, but with all the other changes
ensuing, it seemed like the right time." Smoking became the health issue of the decade while federal funding of family practice graduate medical education and opposition to dual-residencies (FP/IM) were the issues of the day. In 1987 the Academy developed the Teacher of the Year Award and was saddened by the death of June Rose Marchmont-Robinson. The late 80s brought about more change in Academy staff, and
for awhile the IAFP past president William Hulesch, M.D. took over
some staff supervisory duties. 1988 brought about the first logo
for the IAFP (before the Academy simply used the AAFP logo) and a
new look to The Family Physician, and in 1989 the Academy
moved to its 90s a
decade of re-structuring medicine The fifth decade of organized family practice began with a
five-year decline (1988-92) in the number of In 1990, only four of The summer externship program, started with two students in 1990, and peaked with a high of 84 students in 1996. The years following saw fewer placed the program, due to financial limitations, not student interest. Medical students in the externship program spend four weeks between their first and second year of medical school with a family physician to learn what family physicians do each day, as well as what they do in their free time and within their communities. More than 300 students participated in the program during the 90s, with the number growing to well over 700 by 2007. The externship continues to be popular with medical students and hosts about 45-50 students each year. Growth in student interest meant a growth in the number of residency training programs and a 50 percent increase in the number of family practice residents. Unfortunately, the numbers in the late 90s through the
mid-2000s showed a decline in student interest and a loss of
family medicine residencies, as well as fewer residency slots in
the programs that remained. IAFP’s
goal in the 2000s was to increase interest in family medicine
again and educate the public on the importance of the specialty in
caring for all of First
woman elected president of IAFP The final decade of the 20th century brought the
first woman family physician elected president of the IAFP.
Carolyn Lopez, M.D., of “I never felt
resentment or intimations from colleagues that I didn’t belong
there, which is very different from how women
I knew in other fields felt--and still do. Yes, I have broken
through many proverbial glass ceilings, but I have been blessed
with the help of my male colleagues to do it. If I had one thing
to leave you with--male or female--above all, celebrate the
diversity that has become our Academy. Because in that diversity
is tremendous strength and that will keep us going for another
fifty years." It seems Dr. Lopez will not be disappointed as the number of
women in family practice has skyrocketed over the years, and women
now make up nearly 50 percent of Government
relations becomes key The focus on the family physician shortage in IAFP began its government relations program
in 1991 with the hiring of Cook-Witter, Inc., IAFP’s contract
lobbyists, as well as using staff time to work on The combination of lobbyist representation
and directed staff has been instrumental in many legislative,
regulatory and advocacy successes. The
following is a brief review:
Several key opportunities to serve on
statewide coalitions furthered IAFP’s prominence. Among
them: The Safe
Illinois Collaboration, targeting intimate partner violence;
the Illinois Coalition Against Tobacco, whose ultimate goal
was achieved with the passage of a smoke-free Illinois law; The
Medicaid Leadership Group, advocating for continued federal
funding of the Medicaid program and increased Illinois’
financing mechanisms for provider reimbursement; and finally, the Health
Care Justice Campaign, promoting a universal access platform
for Illinois. As more members became active in government
relations, IAFP established its Spring
into Action meeting in 2003, followed by an annual visit to
Capitol Hill with IAFP volunteer leaders in 2004. Since then, family physicians in IAFP’s accomplishments have been recognized
by the The overarching issue of the 1990s was the restructuring of medical care through the growth of managed care and attempts at federal and state healthcare reform. The attempt by U.S. President Bill Clinton and Hillary Rodham Clinton in 1993 and 1994 to institute national health reform put family practice at the center of federal politics. The failure of federal attempts at reform was eclipsed by the speed at which the healthcare marketplace was being transformed by managed care. The effects of the transformation were mainly state-focused and were evident in every aspect of the Academy's programs and services. The Academy board decided to be proactive, assisting members in
dealing with the transformation through new conferences, CME
offerings and feature articles in Family
Physician, which showed how some family physicians were
adapting to the changes. Managed care continued evolving and
family practice worked to shape the future for the benefit of
patients. Changes in the organization of practice saw a decline in the
number of The Academy set a course for family practice to be a leader in the primary care world through collaborative and cooperative relationships with those who wanted to shape the future of primary care. A typical Academy meeting of the late 1990s included not only family physicians, but all the players in the delivery of primary care. Awaiting
the Millennium: the year 2000 promises more change The buzz of the late 1990s and early 2000s included Y2K, managed care, tort reform, evidenced-based CME, coalitions, electronic health records, Medicare Part D, flu vaccine shortages, quality initiatives, universal health care, and more. The constant barrage of change was difficult to stay in front of—and it seemed like more was always on the way. In 1997, IAFP formed the Family Practice
Education Network (FPEN©) as a mechanism to publish and
distribute accredited CME products and services to clinical
primary medical care providers across the
A casualty of these new CME rules was IAFP’s Medicine for Today program, which folded in 2005 after providing CME to members for over 50 years. Just the year before, IAFP earned ACCME accreditation and was approved for reaccreditation in 2006. IAFP’s new CME programming was launched and enduring materials were created as IAFP education modules became a brand. IAFP became involved in Tar Wars in 1998. This new program, aimed at keeping 4th and 5th graders from using tobacco products, was quite successful with over 240 volunteer presenters and 160 schools in its first year. By 2001, IAFP had teamed with the Illinois Department of Public Health and sixteen local health departments to present the program to schools. Each of these departments received funds from the state tobacco settlement fund to spend on tobacco prevention during fiscal year 2001. Unfortunately, the tobacco prevention
programming lost most of its funding after 2001, leaving health
departments struggling and the rest of the health care community
completely cut out. As
a result, the Tar Wars program has had to continually seek funding
elsewhere. The
Tar Wars program is ongoing reaching over 250 schools.
IN the past 10 years, IAFP has reached over 150,000 school
children with this tobacco-free message. In order to keep up with changing
technology and provide members the outlets they need for
participating in IAFP, the 1999 Illinois AFP Congress of Delegates
voted to dissolve itself in favor of an All-Member Congress.
Each year small changes were make to improve how the
business of the Congress runs, culminating in the mid-2000s with a
new All-Member Meeting. As part of the Congress changes, IAFP local chapters were also eliminated and replaced with a system where 10 members could get together form an interest group—whether around a certain area or a certain topic they all felt important. The goal of these changes was to make it easier for any member to participate and contribute their ideas—whether in person or via e-mail, voicemail or “snail mail” (through the post office). There was no stopping a person from participating—regardless of where they might be located or what they might be doing. Year 2000+ The first challenge to transitioning from the 20th to the 21st
century was the concern across the world that many computers would
fail at The years between 2000 and 2007 were up and down for family medicine. Carolyn Lopez, M.D. was elected to the position of AAFP Vice Speaker in 2000. Dr. Lopez was the first Illinois AFP member in 25 years to serve on the AAFP board of directors and was the first woman to hold the position of Vice Speaker on the national level. By 2002 Dr. Lopez had been elected Speaker of the AAFP Congress of Delegates. Unfortunately, in 2004 she lost her bid to become president of the AAFP. IAFP was honored in 2001 with the Award of Excellence by the
American Society of Association Executives “Associations Advance
America” program for involvement in the development of the Reimbursement issues were on the front burner as payment cycles became longer and longer while more and more patients relied on state aid. While by no means is the issue solved, legislation passed in favor of physicians to receive more timely payments. Work continued on receiving higher payments for Medicaid patients. Increasing costs and declining reimbursements forced family physicians to work harder for the same amount of money or simply take home less pay. Meanwhile, malpractice insurance premiums were rising astronomically, crippling every physician’s budget. Many family physicians reduced their scope of practice in order to reduce their “risk” and hopefully their premiums. This reduction of scope was not only in certain procedures, but in hospital care. Many FPs relinquished their hospital privileges and counted on “hospitalists” to care for their hospitalized patients. Practice
no longer Another name change occurred in the mid-2000s when “Family Practice” became “Family Medicine” and its doctors are physicians, not practitioners. This was one of the first changes to come about through the Future of Family Medicine (FFM) project, sponsored by AAFP along with six other organizations. FFM was a two year study, begun in 2002, to produce recommendations which would transform and renew family medicine. The project was released in 2004 after much research and study. It presented a new vision for patient-centered care, based on the concept of a Personal Medical Home. The
FFM Project included 10 recommendations to provide a framework to
guide innovation in three key areas: clinical
practice, medical education and the •
New Model of family medicine •
Electronic health records •
Family medicine education •
Lifelong learning •
Enhancing the science of family medicine •
Quality of care •
Role of family medicine in academic health centers •
Promoting a sufficient family medicine workforce •
Communications •
Leadership and advocacy The mid-2000s also saw a flu vaccine shortage and distribution problem, which overwhelmed the state—and the country. Communication between physicians, pharmaceutical companies, legislators and the media helped to get the message across that physicians must have enough flu vaccine for their most at-risk patients before the general public started getting flu shots at the big box store. Medicare Part D became a reality in 2005, adding another layer of work for already overtaxed family physicians. Assisting senior patients with every detail, from how to sign up, which plan to choose, and answering questions took precious time during appointments as well as many phone calls to their offices. Possibly the biggest news of the decade was that tort reform
was signed into A near immediate effect of the law’s enactment was improved
recruiting of family physicians to Metro East (the “The IAFP has made huge
strides over the past several years in making Illinois a better
place to practice family medicine—as well as a safe, friendly
and cost-effective environment for patients,” says Steven
Knight, M.D., 2007 IAFP president. “Our Academy has kept
its principles from when we started 60 years ago and has improved
upon them as the marketplace has changed.
While many things have changed in medicine over the years,
the basic covenant of caring for our patients is the credo we
continue to live by.” Another legislative breakthrough came in 2007, when Smoke-Free
Illinois was passed in Your
Academy in Lisle IAFP transitioned from tenant to building owner in 2003, as the
Academy purchased the building it had been renting for seven years
on In 2007, IAFP remodeled the front of its building and reconfigured some of the interior space to keep the Academy fresh and staff able to work comfortably and efficiently for members. We encourage any member to drop by and see your Academy any time you are in the area. The Academy is working diligently to ensure that the family physicians of the next 60 years excel and thrive through excellent educational offerings and support. IAFP will continue to be leaders in transforming medicine, and advocates on behalf of family physicians and their patients throughout the state.
The
Illinois Academy of Family Physicians would like
to thank the 50th Anniversary Committee comprised
of Drs. William Hulesch, chair; Robert Heerens;
Boyd McCracken; Lawrence Hirsch; Lawrence Plummer;
and Christi Holz Emerson, IAFP communications
consultant. A
special thank-you is extended to the The
update of material to IAFP’s 60th
Anniversary was written by Christi Holz Emerson,
IAFP vice president of communications, and Ginnie
Flynn, IAFP director of public relations.
It was reviewed by IAFP past presidents
Carolyn Lopez, M.D., Christine Petty, M.D. and
Steven Wilk, M.D. |
