Air Force Consultant Report
04/27/2016

Air Force Consultant’s Report

 

Antoine (Marcus) Alexander, MD
AFMOA, San Antonio, TX
antoin.alexander@us.af.mi

Hello Everyone

It was great seeing those that could make it to the USAFP Annual conference in Denver. It was once again a great success. It was amazing to see all the research and initiatives being done. The theme of the conference was perfect: “Health is Primary.” An emphasis and focus on overall healthy living and its impact. The AFMS vision has this very same message: “Our supported population is the healthiest and highest performing segment of the US by 2025.” Family physicians play a key role in the success of improved health in the AFMS as well as the US. According to research done by the Robert Graham Center, the US will need nearly 52,000 more primary care physicians by 2025. According to the 20th report of the Council on Graduate Medical Education on Advancing Primary Care (www.hrsa.gov), research shows that health care outcomes and costs in the United States are strongly linked to the availability of primary care physicians. Patients with access to a regular primary care physician have lower overall health care costs than those without one, and health outcomes improve. The AAFP reminds us that primary care is the backbone of the health care system. Utilizing primary care physicians puts an emphasis on the physician-patient relationship by shifting the focus from physician-centered care to patient-centered care. An increase of one primary care doctor per 10,000 people has been shown to result in: 5% decrease in outpatient visits, 5.5% decrease in inpatient admissions, 10.9% decrease in ER visits, and 7.2% decrease in surgeries. I say this to remind you that as family physicians, you are highly valued.

A critical component of success in primary care is the relationship between the patient, the physician lead team, and the system within which they function. It is important that we eliminate barriers to establishing trust within this relationship. The patients have to be able to trust that they will receive high quality care and have voiced that one of their keys for this trust is to reliably be able to access the system when desired. Our physicians must be able to trust they will be valued and supported to deliver quality care. The physician satisfaction survey shows concern with not having enough time to complete all of the physician require tasks. During USAFP, I received significant feedback that this overloaded feeling may stem from times when the clinics have vacant provider and or support staff positions. We continue to diligently work to find ways to fill our vacancies in a more-timely and reliable fashion. Lastly, the system must be able to trust that we are consistently utilizing our resources as effectively and efficiently as possible. We must hold each other accountable to be transparent in our workload and the system must find a way to accurately reflect the physician workload including face to face clinical  workload, virtual clinical workload, and required non-clinical workload.

The attendance at the USAFP annual conference was even higher than the previous year when it was held in Washington DC. This hopefully is a reflection of the AFMS taking the lead in adopting new DoD conference approval processes. For those that may not have heard yet, under the new DoD conference guidance, all individuals requesting attendance to a civilian sponsored conferences can now be approved at the unit level. The CARD will not be used in the future as it was in the past and will not be used at all for civilian sponsored conferences. Civilian sponsored conferences will be approved at the local level and process like a normal TDY within everyone’s unit. Conference Packages needing approval are now only limited to AF Hosted conferences costing greater than $100K. DoD Guidance can be found at https://www.my.af.mil/gcss-af/USAF/ep/browse.do?programId=tA4057E1F278FFE4C0127AAEA03D00326&channelPageId=s6925EC13506C0FB5E044080020E329A9. Please continue to leverage the full range of continuing medical education opportunities and please reach out to me if the new process for conference attendance is presenting new barriers.

The AFMS has continued high interest in integrated operational support. This has resulted in the addition of 6 family medicine sports medicine positions in the Elite Performance Initiative Center (EPIC), which takes care of our pararescue force. Thus we now have primary care sports medicine positions at our 6 GME platforms, at trainee health at Lackland, and at USAFA with interest to add positons in AFSOC. If you have an interest in doing sports medicine as a family physician, the time is NOW! I strongly encourage strong family physicians with an interest in an academic or clinically operational career to apply for our sports medicine fellowship this summer through the joint service GME selection board process outlined on the physician education kx page https://kx2.afms.mil/kj/kx4/AFPhysicianEducation/Pages/home.aspx. Also, related to the large volumeof musculoskeletal injuries seen in family medicine, I would like to recommend the RX3 (rehab, refit, and return to duty) tool provided by the human performance resource center. http://hprc-online.org/ physical-fitness. This tool has handouts and videos for common rehab prescriptions. A time saver in your clinic and a desirable way for patients to engage with their own wellness.

The Surgeon General has convened a multidisciplinary leadership meeting to review potential standardized processes to consider Integrative Medicine opportunities within the AFMS. Acupuncture continues to be at the forefront of these opportunities and the SG has expressed clear support for the training and availability of acupuncture and consideration of integrative medicine with a desire to optimize both the quality of care we provide and the ability our Airmen have to complete the mission.

Thank you again for all that you do!