Family medicine has key role in health of the nation, AAFP president says

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On Sept. 25, Jen Brull, MD, FAAFP, assumed the presidency of the American Academy of Family Physicians (AAFP).

The Academy started in 1947 and now represents 130,000 physicians and medical students around the country. It is the largest medical society devoted solely to primary care.

Brull spoke to Medical Economics to introduce herself and to discuss some of the policies and projects that will develop during her term. She also credited the work of her fellow physicians and support staff for their work launching them. “I just was here at the right moment in time,” she said.

Jen Brull, MD, FAAFP
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Brull succeeds Steven P. Furr, MD, FAAFP, a family physician in Jackson, Alabama, who now will serve as AAFP board chair. The election of officers and new board members is part of AAFP’s annual Congress of Delegates, which is followed by the Family Medicine Experience Conference, a celebration of family medicine.

This transcript has been edited for length and clarity.

Medical Economics: Can you introduce yourself and share some information about your education and career?

Jen Brull, MD, FAAFP: I am a family physician and have been in the business of family medicine since med school in the mid-1990s. I went to med school at the University of Kansas in Kansas City, Kansas, and did residency it at the Family Medicine Residency Program of Topeka in Topeka, Kansas. My entire life, I lived, worked in Kansas, until about a year ago, when I transitioned from a clinical practice to an administrative role and moved to Fort Collins, Colorado.

My day job is as vice president of clinical engagement for a company that is called Aledade. Aledade is a company that helps independent primary care practices form accountable care organizations and deliver value-based care. It's a remote role, so I am blessed that I get to live anywhere I want to in the United States, and Fort Collins is a pretty amazing place.

Medical Economics: In your own words, can you explain how important family medicine and primary care are in the American health care system?

Jen Brull, MD, FAAFP: Family physicians make up the principal number of primary care physicians in the United States, particularly in adult medicine. Primary care is foundational to the success of health care delivery in the United States. There are literally 30-plus years of studies, beginning with Barbara Starfield in the 1990s and being augmented with studies as recently as this year, that demonstrate that when patients have access to more primary care, the health outcomes improve, the cost of care goes down. So, it's very clear that there is a key role that family medicine, in particular, and primary care broadly, plays in the health of the United States. The challenge is, there are not enough primary care physicians, and the current estimates are that we will be short in the 10s of 1000s within the next 10 years. That is a combination of both a large generation retiring from the practice, and some consequences of burnout, as well as, although there are more people going into family medicine every year, there are not enough to refill the bucket that is being emptied by those exiting clinical medicine.

Medical Economics: In terms of your own organization's policy, national policy, or other factors, what could be done to attract more young doctors to family medicine?

Jen Brull, MD, FAAFP: I've got lots of ideas there, and the AAFP has lots of strategies there. We actually just refreshed our strategic plan for the next three years that will launch in 2025 and I shared it during my address to the Family Medicine Experience main stage last week, which was exciting. I think all of the pieces of this strategic plan will help increase the number of people going into family physicians. The four groups are, elevating the voice of family medicine, making sure that when we're having conversations about health care across the United States that there's a family doctor in the room. They are enhancing physician well-being, which is really important for that group of people that we want to stay with joy in their practice and not leave the clinical practice of medicine early due to symptoms of burnout. We are also working on improving systems, which means things like improving the existing fee-for-service system for those who are still participating in that, and ensuring that as family physicians move to a value-based care world, that the landscape they find there is supportive and values family medicine and primary care writ large. Perhaps the greatest impact, however, that we will have is about strengthening our future. We just launched a major project to partner with med students of this generation, learn from them what is critically important to them, what attracts them to our specialty, what challenges them and keeps them from being in our specialty and to partner around solving that. It is very clear that when you have a primary care workforce that looks like the communities they serve, health outcomes are better. So we are committed to recruiting and training and guiding a very diverse workforce, which begins with making sure that students from rural areas, underprivileged or underrepresented backgrounds, make it to med school and then have a path by which family medicine is both attractive and affordable for them to continue.