Board Reports

President's Report

John Rogers, MD, MPH, MEd

It has been a distinctive privilege to be president of STFM. This organization has been my academic home for 30 years. I have learned much and grown substantially from attending Families and Health, Predoctoral Education, and Annual Spring Conferences, where I made friendships spanning 3 decades. The past 4 years, starting as secretary-treasurer, has been my second opportunity to be on the Board of Directors and contribute back to a small degree what I have gained from my colleagues and this association. The list of names of those who have shaped my career and to whom I am grateful is too long for this report, but I thank each one of you for how you enriched my career and my life. I thank the members of the Board of Directors who have worked hard this year to steer our Society in a time of significant change for STFM and family medicine. I also thank all of the STFM members who have contributed their time and energy on STFM committees, groups, task forces, initiatives, work groups, and liaisons and who responded graciously to our requests. Lastly, I thank all of you for working every day in your local setting for the future of family medicine.

In my charge to the Board of Directors at our first meeting last April, I outlined six goals for 2007-2008:

1. Find a successor for Roger Sherwood, CAE, as executive director when he retires
2. Reassess our mission statement
3. Maintain and strengthen our core membership services
4. Contribute to the emergence of the Council of Academic Family Medicine
5. Energize the Priority Programs of the Special Task Force on the Future of Family Medicine
6. Champion the assembling of patient-centered medical homes

We have made amazing progress on these goals.

(1) Find a successor for Roger Sherwood
The Search Committee began its work in December 2006 by outlining the skills critical to success of the next STFM executive director and the selection process. The Search Committee conducted a national search, received nearly 50 applications, reviewed in detail the credentials of 20 candidates, invited seven for personal interviews, and invited three finalists to present to the STFM staff and Search Committee at the STFM offices. Upon the recommendation of the Search Committee, the STFM Board of Directors voted unanimously to select Stacy Brungardt, MA, CAE, as the next executive director of STFM effective October 1, 2007.

Stacy brought a long history of association management experience, deep understanding of STFM and academic family medicine, and outstanding organizational and leadership skills to her new position. She served as the STFM communications director from 1993 to 2000, when she was promoted to STFM deputy executive director. That same year, she was appointed executive director of the North American Primary Care Research Group (NAPCRG). Stacy has proven success as the executive director of NAPCRG; proven ability at growing an association in terms of finances, number of members, quality of programs, and organizational reputation; skill at facilitating boards, committees, and staffs toward the accomplishment of objectives; and skill developing partnerships and coalitions with key individuals from other associations. She worked with Roger Sherwood to ensure a smooth transition with his retirement on October 31, 2007, and with the Transition Committee since that time. This goal has been achieved exceedingly well!

(2) Reassess our mission statement
This process began under the leadership of Bill Mygdal, EdD, of the Strategic Planning Committee in 2006–2007 and continued under the leadership of Caryl Heaton, DO, in 2007–2008. There was consensus among the committee to reassess STFM’s mission statement following the visioning process outlined by Jim Collins in Built to Last, which starts with discovering the organization’s core values and purpose.

Committee members began by composing and submitting statements that captured STFM’s core values and then using appreciative inquiry questions to tap into committee members’ perceptions of the values that are in play when STFM functions really well. Two small groups worked separately and independently identified core values that are an enduring part of our organization present over the long term. The groups also considered and proposed core purpose statements in their deliberations. The committee presented the lists of values to the Board of Directors to engage the Board in the process and get initial reactions from the Board. The Committee then conducted a process for finalizing the values selection and limiting it to six, following Jim Collins’ experience that values are unlikely to be really core if there are more than five or six. The committee agreed on six values and presented them to the Board of Directors at its August 2007 meeting, which were discussed in detail, revised, and formally adopted at the Board’s November 2007 meeting. The committee then worked to finalize a core purpose statement, which it presented to the Board at its January 2008 meeting. The Board engaged in a considered discussion and approved a final statement.

Core Values

• Integrity
• Relationship centered
• Openness
• Nurturing
• Excellence
• Learning

Core Purpose

• Advancing Family Medicine to Improve Health Through a Community of Teachers and Scholars

We have discovered our core values and core purpose and will use them to guide our decisions to assure alignment between our core and our programs and activities.

(3) Maintain and strengthen our core membership services
Our core membership services are our conferences, publications, digital resources library, Web site, advocacy efforts, and opportunities to network and work together with colleagues with similar interests in our groups. The Practice Improvement, Predoctoral Education, Families and Health, Behavioral Science Forum, and Annual Spring Conferences continue to provide members with venues for learning, sharing, and interacting with peers. Family Medicine and Annals of Family Medicine are highly regarded peer-reviewed journals that provide members with access to cutting-edge innovation and research, scholarly interchange, and publication opportunities. The STFM Messenger provides timely online updates about STFM activities and other items of interest to members. The Family Medicine Digital Resources Library (www.fmdrl.org) provides online access to more than 1,000 teaching resources prepared by STFM members and available free for use in educational efforts. The Communications Committee has hired a consulting firm to assess the FMDRL user interface and offer recommendations for usability enhancements. The STFM Web site provides members with information about the Society and its conferences, publications, and other resources, including a membership directory and list of group members for networking. A major new initiative this year was the STFM Foundation Group Grant Program where groups could apply for up to $10,000 for a 2-year project. The STFM Executive Committee reviewed the submitted proposals and selected four for funding:

• Adolescent Health for Primary Care: Development of a Web-based, Comprehensive, Competency-based Curriculum—Group on Adolescent Health
• Overcoming Obstacles to Writing for Family Medicine Educators—Group on Minority and Multicultural Health Care
• Teaching E-mail Communication in a Residency Program—Group on Information Technology
• Outgoing Third-year Family Medicine Resident Satisfaction—Group on Behavioral Science

Our core services continue to improve to meet the needs of our members.

(4) Contribute to the emergence of the Council of Academic Family Medicine (CAFM)
CAFM is composed of the presidents and executive directors of all of the family medicine academic organizations: Association of Departments of Family Medicine (ADFM), Association of Family Medicine Residency Directors (AFMRD), North American Primary Care Research Group (NAPCRG), and STFM. From the CAFM Charter:
"Background
Recent collaborative projects involving our various family medicine organizations, including the Future of Family Medicine project and the Annals of Family Medicine, have pointed out both the urgency and the potential power of working collaboratively and with a unified voice. In response, our academic organizations have recognized that increased collaboration would help us in unifying our voice, becoming more responsive, and increasing our collective impact. Therefore, in August 2006, ADFM, AFMRD, NAPCRG, and STFM committed to develop a new coalition, titled the Council of Academic Family Medicine (CAFM), to combine their efforts more effectively.

Purpose of the New Coalition

1. The coalition will provide a unified and unifying voice for issues of concern to academic family medicine and its constituent organizations.
2. The coalition will perform an environmental scan, prioritize across issues, speak with a unified voice reactively and move proactively to confront the issues facing the discipline.
3. The coalition will address major issues confronting the discipline and will take independent action and/or delegate to individual organizations as appropriate.
4. The coalition will emphasize action, accountability, and follow through, balancing the need for rapid action with due deliberation according to the needs of the issue.”

CAFM meets every 6 months and holds monthly conference calls. At its meeting in January 2007, it finished an environmental scan SWOT analysis and selected priority joint projects for action. The final SWOT analysis provided a context for choosing the joint projects, which were prioritized by ratings of impact and feasibility. Six projects were selected:

• NBME Family Medicine Clerkship Exam—work with NBME to develop a more appropriate family medicine clerkship shelf exam.
• Shared National Internet Curriculum—explore the need and feasibility of a national shared residency online curriculum
• Hospitalist Impact—prepare a paper reviewing evidence of efficacy, impact on family physicians, impact on learners, implications for our educational programs, and opportunities for research
• Revenue Enhancement—identify and disseminate a list of opportunities for how people can enhance revenue in academic settings
• Public Relations—work with AAFP to improve public relations for family medicine
• OB Requirement in FM—initiate discussion of potential change in the current residency requirements

CAFM members and organizations took responsibility for starting action on the projects, such as creating work groups that involve other individuals who are in positions critical to the success of the projects. CAFM met in August 2007 to report on progress and reassess the status of the projects, which led to elimination of the public relations item. At its January 2008 meeting, it conducted another SWOT analysis and added a project:

• Teaching practices as patient-centered medical homes—summarize efforts to create teaching practices for both medical student clerkship rotations and residency rotations that are medical homes including the available measures of the medical home

CAFM has been functioning for only a little more than a year but has emerged as an effective way to coordinate the efforts of the member organizations to address important issues of concern to all of us in academic family medicine. STFM is a full partner in CAFM and has contributed to its emergence.

(5) Energize the Priority Programs of the Special Task Force on the Future of Family Medicine
In 2005, the Board created a Special Task Force to coordinate STFM’s responsibilities for achieving the strategic initiatives in the Future of Family Medicine Report. The Special Task Force was renewed in 2007 for an additional 2 years ending in 2009. Its goals are to continue current Priority Programs, to initiate a Leadership Development Program, and to integrate STF Priority Program into ongoing responsibilities of STFM committees and groups to ensure continued achievement of FFM responsibilities after the STF’s second term ends.

Priority Programs:

• Development of competency-based instructional units for the patient-centered medical home: quality improvement, chronic care model, EHR, advanced access, and group visits—these modules are available at www.fmdrl.org and are the subject of a series of articles in The STFM Messenger from the Education Committee—the ADFM Clinical Committee was impressed with the structure and quality of these modules and will be developing a module on pay for performance.
• Creation of the FutureFamilyDocs program, a multifaceted approach to promote mentoring between family physicians and young people in their practice communities to increase their eventual entry into family medicine. This project includes an innovative Web presence, www.futurefamilydocs.org—the Web site continues to evolve, articles on mentoring stories continue in The STFM Messenger, and STFM and the National AHEC Organization signed a letter of understanding to work together on mentoring efforts.
• Development of a 2-day program—IMG Entering Resident Academy—to better prepare individuals accepted into a family medicine residency program about the essentials of graduate medical education and the US health care system—the Academy had a successful pilot program in May 2007 and will be repeated May 8–10, 2008, in Philadelphia and June 6–8, 2008 in Chicago.
• Leadership Program to identify and develop emerging leaders—a summary of leadership development training programs is available at http://www.stfm.org/leadership/index.htm—a survey on leadership needs has been completed with respondents indicating that STFM is best prepared to develop these efforts, which should be a priority for STFM in the next 5 years—this project has a leadership incubator perspective and will be creating ways to identify and develop “emerging leaders” in STFM groups and committees.

These Priority Programs are becoming mature and will continue as they become integrated into STFM’s organizational structure.

(6) Champion the assembling of patient-centered medical homes
STFM has advocated for the patient-centered medical home (PCMH) model of primary care through its publications and conferences, by linking with other organizations, and by starting a new initiative. Members of the Board of Directors have written articles for the “The PCMH: Perspectives From the STFM Board of Directors” column in The STFM Messenger where the Board members examined the PCMH from the viewpoint of their role on the Board, such as committee chair, member-at-large, or CAS representative, student representative, resident representative. My President’s Columns in Family Medicine have covered a number of facets of this focus:

• Is This Focus on Patient Care a Distraction from STFM’s Primary Mission?
• The Care Principles
• The Promise and Price of the Infrastructure Principles
• Teaching Resources
• The Clerkship Initiative
• Assembling Patient-centered Medical Homes in Teaching Practices—One Strategy

STFM-sponsored conferences have had the PCMH as a theme this year:

• Conference on Families and Health—“The Medical Home Team: Collaborating With Families and Communities to Restructure Health Care”—February 28–March 2, 2008, New Orleans
• Annual Spring Conference—“Strengthen the Core, Stimulate Progress: Assembling Patient-centered Medical Homes”—April 30–May 4, 2008, Baltimore
• The Forum for Behavioral Science in Family Medicine—“Integrating and Expanding Behavioral Science in the New Medical Home”—September 25–28, 2008, Chicago
• Conference on Practice Improvement: Health Information and Patient Education—“Blueprint for the Medical Home”—December 4–7, 2008, Savannah, Ga

STFM is working with CAFM on PCMH efforts as noted above but also was the first academic organization to join the Patient-centered Primary Care Collaborative (PCPCC), which includes more than 100 organizations. We were followed by the Society of General Internal Medicine, the Society of Primary Care Fellows, and the Association of Departments of Family Medicine. The organizations in the PCPCC represent the full array of constituencies that have a vested interest in the future of primary care:

• Physician professional organizations
• Health systems, hospitals, and other organizations providing health care services
• Pharmacy companies
• Pharmaceutical companies
• Health quality and health care improvement organizations
• Academic departments, medical centers, and organizations
• Insurance companies
• Employers and business organizations
• Patient groups

The PCPCC is active in advancing the PCMH as the future for primary care in the United States, including federal legislation and large demonstration projects. See www.pcpcc.net for more information on this large effective collaborative.

Lastly, the STFM Clerkship Medical Home Initiative (CMHI) is adding an important project for advancing the PCMH. The field has active national projects for residency education (P4 Project) and practice transformation (TransforMED). The missing element is a project focused on the clinical experience of third-year family medicine clerkship students, which is a pivotal time for specialty selection. The goal of the CMHI is to understand efforts to spread the PCMH model to clerkship teaching practices. The rationale for the initiative is that the field of family medicine needs to know the current status of clerkship PCMH clinical experiences and to learn how predoctoral programs are attempting to remodel their clerkship clinical practice sites to expose students to the principles of the PCMH model. The STFM Research Committee has designed a baseline study that assesses the PCMH features of systematically selected clerkship teaching practices. This will be followed by a 2-year observational project that will document and share information about strategies implemented by predoctoral and clerkship directors to achieve PCMH features in clerkship practices. A follow-up study of practices will be conducted at the end of the 2 years.

STFM has vigorously advanced the PCMH model of practice during a year that has seen dramatic spread of this model since the initial release of the Joint Statement of Principles in February 2007. We have done well at championing this vision for our future clinical care and teaching.

As many of you know, I am a whitewater rafter, mountain climber, and marathoner. If STFM were a person, it could say the same thing. Our organization has been in class IV and V rapids this year with its internal changes and external challenges and opportunities. Our organization has set high goals and ascended to new heights of achievement. Our organization has paced itself and shown sustained endurance. STFM has demonstrated that it is agile enough to respond rapidly to change, ambitious enough to reach high, and disciplined enough to last. I thank you again for a wonderful, unforgettable year as your president. Here’s the baton…