29th National Conference on Primary Health Care Access to be held in Monterey, California

The Coastal Research Group hosts the invitational National Conferences on Primary Health Care Access. For the 29th National Conference, we return to the Hyatt Regency Monterey. site of the 1993 and 2009 National Conferences.

The 29th National Conference will take place April 16 through 18, 2018.  The theme of the 29th National Conference will be “What Appears Certain”.

The founding of the Coastal Research Group 34 years ago and the establishment of the National Conferences on Primary Health Care Access in 1990 were both based on the premise that the American health care system was in need of substantive reform.

Although there are many admirable features of American medicine and comprehensive reform has been attempted through 2010’s Patient Protection and Affordable Care Act (PPACA), very serious deficiencies still exist in how American health care is organized and financed. How these deficiencies are to be resolved and how such gains as have been made are to be protected will be the subject of discussion at the National Conference.

PPACA, to which the media have assigned the nicknames “ACA” and “Obamacare” has had a transformative impact on some aspects of the health care system. Yet, although the ACA, at the time of the 29th National Conference will have been enacted for more than a half-decade, its ultimate efficacy and impact is still a source of intense debate.

Whatever its ultimate impact, the problems that brought forth the National Conferences – the geographic and specialty distribution of physicians, the lack of an appropriately functioning system of primary care, the lack of effective integration of medicine and public health – all remain concerns.

Over the past 28 National Conferences, much of the discussion has not only identified what should be changed in the health system, but has assessed the intended and unintended consequences of past federal legislation (i.e, Medicare, Medicaid and the prescription drug benefit).

These concerns are at the center of discussion of each of the National Conferences.

The Contemporary Political Climate

The Patient Protection and Affordable Care Act has yet to gain the widespread popularity predicted by the legislation’s proponents. Nor has consensus yet emerged at the federal level as how to change it.

A Brief History of the Concept of Primary Health Care Resources

Over a half century ago (1964), the treatise “Health Care is a Community Affair”, called the Folsom Report, was published. The next year (1965), the two principal federal programs for funding health care, Medicare and Medicaid passed, followed in the subsequent year, by the publication of the reports of the Millis and Willard Commissions.

The three reports and two financing mechanisms have had profound results, the former on development of public and private sector policies the latter on how the structure of American health care evolved.

The reports resulted in such familiar concepts as the idea of primary and tertiary health care, programs to address geographic and specialty maldistribution of physicians, especially in rural and “inner city” areas, and creation of new primary health care personnel.

In the meantime, multiple efforts to address poverty in America at the federal level led to the creation of the Office of Economic Opportunity, which promoted such ideas as Neighborhood Health Centers.

With the change in administrations at the federal level in 1968, many of the OEO ideas were institutionalized (made politically more “acceptable”) in federal legislation supporting the Community Health Centers and the National Health Service Corps. Legislation funding the new primary care discipline of Family Medicine passed at the same time as the other “safety net” programs, that had consequences for the evolution of training the family physician.

The effects of the two financing mechanisms were outsized, impacting the structure and organization of any entity that received funding from either. Neither Medicare and Medicaid were developed in concert with the policy recommendations of the Commissions, and thus a half-century of accumulated evidence suggests that the policy bases of health care financing do not synchronize with the policy bases would underlie a rational American health care system.

Issues for further consideration by the 29th National Conference 

The following questions, all of which were posed for and discussed at the previous National Conferences, are posed for the faculty and invited participants for the 29th National Conference as well.

  • What were the changes in American Health Care intended by passage of the “ACA”? To what extent have such changes been effected, with the likelihood that the change is permanent?
  • Are there unintended changes that have occurred through passage of the “ACA”? Are those changes good or bad?
  • Because Medicaid historically has differed significantly from state to state, ACA attempted to impose a more consistent approach to the financing of Medicaid recipients between states. To what extent has this effort been successful, and where do problems still exist?
  • Insurance companies, which evolved historically to assess and contain risk, have been assigned by the ACA the task of advancing the “rights” of health care recipients to care (whom ACA obligated to enroll in a health plan) while charging them with the plan’s actuarial costs. Is this the best way to increase access to health care?
  • Has the “ACA” enhanced or impeded primary health care access in rural communities, and to “underserved” and disadvantaged populations? What is the anticipated impact of the November 2016 election on the ACA’s progress in providing care access?
  • What are the effects of changes being implemented in the accreditation of medical schools and postsecondary physician training programs?
  • How are such innovations as primary care medical homes, teaching community health centers, rural training tracks, hospital-centered community health plans, and accountable care organizations faring? Are there examples of programmatic successes (or failures) that would be of general interest?

Invitations to the 29th National Conference were sent out in the latter half of 2017.  Those persons intrested in more information on the National Conferences and the Invitation process,  should e-mail the conference coordinator, William H. Burnett, at [email protected]

“What is Certain”: Program Highlights of the 29th National Conference on Primary Health Care Access

Each day of the 29th National Conference day has a general theme – Monday April 16th will include discussions of National healthcare policy including the status of the Patient Protection and Affordable Care Act (ACA) predictions of the impact on ACA of 2017’s comprehensive tax bill on ACA and related discussions.
On Tuesday April 17th issues of primary care access for various populations, including those living in rural settings or in low socieoeconomic urban areas of neighborhoods with large numbers of ethnic, racial, linguistic and cultural minorities or LGBT persons reside.
On Wednesday April 18th would be health professional school/physician training program strategies for increasing the numbers of culturally competent Primary Care physicians who serve geographic, socioeconomic, ethnic and other minorities.
 
HIghlights of each day’s program will be posted in the days ahead.

29th National Conference on Primary Health Care Access: Plenary Faculty

The following is a preliminary list of confirmed faculty for the Coastal Research Group’s 29th National Conference on Primary Health Care Access (confirmed as of January 30, 2018).

Additional confirmed faculty will be listed soon.

 

Denise Crawford, MBA
Family Health Center, Kalamazoo, Michigan

Suzanne Allen, MD, University of Washington WWAMI, Boise, Idaho

Marc E. Babitz, MD, State of Utah Department of Health, Salt Lake City

John Boltri, MD, Northeast Ohio University, Rootstown, Ohio

William H. Burnett, MA, The National Conferences on Primary Health Care Access, Granite Bay, California

Maria Carriedo-Ceniceros, MD, San Ysidro Health Center, San Ysidro, California

Peter Coggan, MD, Bellingham, Washington

Denise Crawford, MBA, Kalamazoo Family Health Center, Kalamazoo, Michigan

John Geyman, MD
University of Washington Emeritus Faculty

James Cruz, MD, Molina Medical Centers, Long Beach, California

Delight Erickson, RN, FNP, Sutter Health, Los Banos, California

Enrique Fernandez, MD, Ross University, Miramar, Florida

Hector Flores, MD, White Memorial Medical Center, Los Angeles

Virginia Fowkes, FNP, MHS, Stanford University, Palo Alto, California

Joshua Freeman, MD, Tucson, Arizona

Donald R. Frey, MD, Creighton University, Omaha

John Geyman, MD, University of Washington  Emeritus, Friday, Harbor, Washington

Ivan Gomez, MD, University of California San Francisco/Fresno Center, Fresno

Mark Goodman, MD, Creighton University, Omaha

Jimmy Hara, MD, Charles R. Drew University, Los Angeles, California

Tim Henderson, George Mason University, Fairfax, Virginia

James Herman, MD, MSPH, University of Oklahoma, Tulsa

Thomas HInes, MD, Boston University, Boston

Gary LeRoy, MD, Boonshoft School of Medicine, Wright State University, Dayton, Ohio

Jimmy, Hara, MD
Charles R Drew University, Los Angeles

Amy L. McGaha, MD, FAAFP, Creighton University, Omaha 

Walter W. Mills II, MD, Natividad Medical Center, Salinas, California

Scott Nass, MD,  Citrus Valley Health Partners Family Medicine Residency, West Covina, California

William A. Norcross, MD, University of California, San Diego

Charles Q. North, MD, MS, University of New Mexico, Albuquerque

Keosha Partlow, Ph.D., Charles R. Drew University, Los Angeles

Robert Ross, MD, Saint Charles Medical Center, Bend, Oregon

Jill Rush-Kolodzey, MD, Louisiana State University, Shreveport

Emilio Russo, MD, Louisiana State University, New Orleans

Joseph E. Scherger, MD, MPH, Eisenhower Medical Center, Palm Springs, California

Frederic N. Schwartz, DO, FACOFP, A. T. Still University, Mesa, Arizona

David Sundwall, MD
Univesrity of Utah

Caryn Slack, MD, Molina Medical Centers, Salt Lake City

David Sundwall, MD, University of Utah, Salt Lake City

Daniel Webster, MD, Michigan State University

Andrea Wendling, MD, Michigan State University

Allan Wilke, MD, Humboldt Medical Specialists, Eureka, California

Mike Witte, MD, California Primary Care Association, Sacramento, California

The National Conferences’ Named Lectures

G. Gayle Stephens, MD (right) with 12th Stephens Lecturer John Geyman, MD

The Coastal Research Group has sought to honor major intellectual leaders in the Family and Community Medicine movements.  Typically, each of the National Conferences on Primary Health Care Access has one of three named lectures associated with the conference.  One honors G. Gayle Stephens, MD, one honors the late Charles E. Odegaard, Ph.D. and the third honors J. Jerry Rodos, DO.  The lecturers in each series include many eminent figures in these movements.

The National Conferences have established named lecture series to honor three colleagues who have achieved prominence in their professional careers, and have additionally made significant contributions to the National Conferences. Continue reading “The National Conferences’ Named Lectures”

Doctor Sundwall Scheduled for Keynote of 29th National Conference on Primary Health Care Access

David N. Sundwall, MD; University of Utah
David N. Sundwall, MD; University of Utah

Doctor David Sundwall will provide the keynote presentation at the 29th National Conference on Primary Health Care Access. The conference will be held April 16-18, 2018 at the Hyatt Regency Monterey (California).

A member of the University of Utah medical school faculty, Doctor Sundwall has served as Director of Public Health for the State of Utah.

He previously had served as Head of the United States Department of Health and Human Services’ Health Resources and Services Administration [HRSA] under Presidents Ronald Reagan and George H. W. Bush.

Previous to that, Dr Sundwall was Minority Consultant (staff member to vice-chair Senator Orrin Hatch) on the United States Senate Labor and Health Committee, chaired by Senator Ted Kennedy.

During Doctor Sundwall’s tenure at HRSA, he oversaw many progressive public health initiatives, including the rejuvenation of the National Health Service Corps [NHSC] and the creation of the NHSC Loan Repayment Program and the Ryan White Act. He is a strong advocate of legislation that advances national public health goals.

Doctor Sundwall’s presentation will discuss the policy issues and politics surrounding the Patient Protection and Affordable Care Act [ACA], still popularly known as ObamaCareHe is a critic of the characterizations of ACA by both the Republican and Democrat political establishments and their campaign operatives.

Doctor Sundwall will address the specific proposals under consideration by He will analyze the role of the state governors (a majority of whom are of the same party as the President and Congress) in proposing how ACA should be changed, as well as how Medicaid should be administered in the future.

“Access”: Day Three of the 28th National Conference on Primary Health Care Access – April 12, 2017

This page follows:  “Access”: Day Two of the 28th National Conference on Primary Health Care Access – April 11, 2017

The schedule for April 12, 2017 (third day of the 28th National Conference on Primary Health Care Access) is as follows:

6:30 AM Breakout Groups (with Breakfast) conference registrants only)

Suzanne Allen, MD

8:15 AM Call to Order (Gary LeRoy, MD, Wright State University, Moderator) [Doctor LeRoy is a Senior Fellow of the National Conferences]

8:20 AM The 24th Charles E. Odegaard Lecture

   Suzanne Allen, MD, University of Washington School of Medicine, Boise, Idaho

8:50 AM Questions and Comments – Lead Question: Charles Q. North, MD, MS [Doctor North is a Senior Fellow of the National Conferences] Continue reading ““Access”: Day Three of the 28th National Conference on Primary Health Care Access – April 12, 2017″

“Access”: The 28th National Conference’s Breakout Groups – Wednesday April 12 2017

Mardi Gras Face Mask 

The breakout question April 12, 2017

Mark E. Clasen, MD, Ph.D., The Third Charles E. Odegaard Lecture, March, 1996

“In [a Houston, Texas] community health center, a very ill subset of diabetic patients were getting sicker. In this group hemoglobin A1C’s were climbing, and visual and extremity complications were worsening. The physician group asked our diabetic teaching nurse, Gloria O, to break out of her prescribed protocols, and render this group of patients intensive outpatient care. Listening to her counsel her patients in a new way, I heard her use language and imagery that I had never heard her use before. Continue reading ““Access”: The 28th National Conference’s Breakout Groups – Wednesday April 12 2017”

“Access”: Day Two of the 28th National Conference on Primary Health Care Access – April 11, 2017

This page follows: “Access”: Day One of the 28th National Conference on Primary Health Care Access – April 10, 2017

The schedule for April 11, 2017 (second day of the 28th National Conference on Primary Health Care Access) is as follows:

6:30 AM Breakout Groups (with Breakfast) conference registrants only

8:15 AM Call to Order (Ana Bejinez-Eastman, MD, Presbyterian Intercommunity Hospital, Whittier, California, Moderator) [Doctor Bejinez-Eastman is a Senior Fellow of the National Conferences]

8:20 AM Issues in Primary Health Care Access: A Conversation

  Norman B. Kahn, Jr, Council of Medical Specialty Societies, Chicago [Doctor Kahn is a Senior Fellow of the National Conferences]

  Jeffrey Susman, MD, Dean Emeritus, Northeast Ohio Medical College, Rootstown, Ohio

  Donald Frey, MD, Vice-Provost Emeritus, Creighton University, Omaha, Nebraska [Doctor Frey is a Senior Fellow of the National Conferences]

8:40 AM Audience Questions and Comments – Lead Question: J. Scott Christman, MPDS [Mr Christman is a Fellow of the National Conferences] Continue reading ““Access”: Day Two of the 28th National Conference on Primary Health Care Access – April 11, 2017”

“Access”: The 28th National Conference’s Breakout Groups – Tuesday April 11 2017

The Twenty-Eighth National Conference on Primary Health Care Access, at the Hyatt Regency New Orleans (second day breakout groups):

The steamship Natchez on the Mississippi River, New Orleans

THE APRIL 11, 2017 SMALL GROUP QUESTION

An excerpt from Peter V. Lee, MD’s  “The Student, the Patient, and the University” 1965

“The motivation of most physicians must ultimately arise from an interest in the problems of their patients; the patient-oriented curriculum would utilize this motivation from the beginning.  …..And now..my hopes for the future:  Continue reading ““Access”: The 28th National Conference’s Breakout Groups – Tuesday April 11 2017”

“Access”: Day One of the 28th National Conference on Primary Health Care Access – April 10, 2017

The schedule for April 10, 2017 (first day of the 28th National Conference on Primary Health Care Access) is as follows:

6:30 AM Breakout Groups (with Breakfast)  (conference registrants only)

8:15 AM Welcome and Review of the Previous 27th National Conference

J. Scott Christman, MPDS, Office of Statewide Health Planning and Development, Sacramento, California [Mr Christman is a  Fellow of the National Conferences]

8:25 AM Opening Statement of the First Plenary Session (Marc Babitz, MD, Utah Department of Health, Moderator) [Doctor Babitz is a Senior Fellow of the National Conferences]

Recognition of William A. Norcross, MD, University of California, San Diego, as a new Senior Fellow of the National Conferences

Recognition of Denise Crawford, MBA, as a new Fellow of the National Conferences

Charles Q. North, MD

8:30 AM Theme Panel: “Access to What?: Issues in  Access to Primary Health Care”: A Discussion by Charles Q. North, MD, Jeremy Fish, MD and William H. Burnett, MA

Charles Q. North, MD, MS, University of New Mexico, Albuquerque, [Doctor North is a Senior Fellow of the National Conferences]

Jeremy Fish, MD, John Muir Health Systems, Walnut Creek, California

Jeremy Fish, MD

William H. Burnett, MA, Coastal Research Group, Granite Bay, California [Mr Burnett is a Senior Fellow of the National Conferences]

William H. Burnett, MA

Continue reading ““Access”: Day One of the 28th National Conference on Primary Health Care Access – April 10, 2017″