“Access”: The 28th National Conference’s Breakout Groups – Monday April 10 2017

The first event of the 28th National Conference, which opens on Monday April 10, 2017 at the Hyatt Regency New Orleans are seven breakout groups (with breakfast) with an assigned discussion topic.

French Quarter Crowds near the Cafe du Monde

THE APRIL 10, 2017 SMALL GROUP QUESTION

The following question was a breakout question for the 18th National Conference on Primary Health Care Access, held in April, 2007, three years before passage of the Patient Protection and Affordable Care Act.

Imagine the opportunity for a new discussion of the core elements of PPACA. Would the concerns suggested by the April 2007 question still be relevant today?

“You have been appointed to a citizen’s advisory group that is reporting to Congress on plans to provide health coverage for all uninsured person in the United States.  You notice that most members of the advisory group are content to recommend spending whatever it takes to make the current system of care available to everyone.  

“You have become concerned about the advisory group making such a recommendation without concurrently recommending reform of the health care system and new attention to the geographic and specialty distribution of the workforce.  How do you articulate your concerns in ways that would help focus the public policy debate?”

The breakout group breakdown:

MONDAY APRIL 10, 2017 

6:30 AM

Group One, BEJINEZ-EASTMAN (LEAD); ALLEN (SCRIBE), North, Soto, Susman

Group Two, BOLTRI (LEAD); ERICKSON, (SCRIBE): Babitz, J.Geyman, Kahn

Group Three, R.FLINDERS (LEAD); E.GEYMAN (SCRIBE); Burnett, Fish, Gomez, Righter

Group Four, FREY (LEAD); J.FLINDERS (SCRIBE), Chiang , Harrison, North, Porfeli

Group Five, LEROY (LEAD); PARTLOW (SCRIBE), Christman, LePage, Rush-Kolodzey, Webster

Group Six, ROSS, LEAD; ZRYD SCRIBE; Coleman, Matheny, Neiman-Hart, Wilke

Group Seven, NORCROSS, LEAD; SPALDING SCRIBE: Crawford, Graves, Russo, Sheridan

 The assigned breakout question will be posted soon.

National Conference Scholar Positions Established for 23rd through 28th National Conferences on Primary Health Care Access

Over the past 28 years, the National Conferences on Primary Health Care Access have been conducted by the Coastal Research Group, a non-profit 501(c)(3) corporation, dedicated to the advancement of the goals of family and community medicine and public health.

The National Conferences are invitational and invitations are by tradition first offered to previous National Conference registrants. Therefore, each conference consists of large majority of conferees who have attended one or more previous conferences in the  series.

Those persons who have made plenary presentations and have attended specified numbers of National Conferences are designated as Senior Fellows or Fellows of the National Conferences. [The Senior Fellows and Fellows are listed at Fellows and Senior Fellows of the National Conferences on Primary Health Care Access.]

At the 23rd National Conference in Carlsbad, California a new position of honor was created, the National Conference Scholars. Each of these is a newcomer to the National Conferences, and whose Scholarship has been sponsored by his or her institution as a National Conference participant.

Each National Conference Scholarship bore the name of a current Fellow or Senior Fellow, except for two Memorial National Conference Scholarships honoring a deceased Fellow and Senior Fellow.

The 2017 National Conference Scholars

Jeremy Fish, MD, Muir Healthcare, Walnut Creek, California, has been designated the 2017 Charles Q. North, MD, MS National Conference Scholar

Jessica Flinders, FNP, has been designated the 2017 Marc E. Babitz, MD National Conference Scholar

Ivan Gomez, MD, UCSF Fresno, has been designated the 2017 James Herman, MD National Conference Scholar

Lisa Graves, MD, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, has been designated the 2017 Donald Frey, MD National Conference Scholar

Steven Harrison, MD, Natividad Medical Center, Salinas, California, has been designated the 2017 Rick Flinders MD National Conference Scholar

Kenneth LePage has been designated the 2017 J. Scott Christman National Conference Scholar

Holli Neiman-Hart, MD, has been designated the 2017 John Boltri, MD National Conference Scholar

Erik Porfeli, Ph.D., has been designated the 2017 Gary LeRoy, MD National Conference Scholar

Lisa Righter, MD, has been designated the 2017 Ana Bejinez-Eastman, MD  National Conference Scholar

Emilio Russo, MD, has been designated the 2017 John Geyman, MD National Conference Scholar

Valerie Sheridan, DO, has been designated the 2017 William A. Norcross, MD National Conference Scholar

Lisandra Soto, DDS, has been designated the 2017 Samuel Matheny, MD National Conference Scholar

Jeffrey Susman, MD, has been designated the 2017 Norman B. Kahn, Jr, MD  National Conference Scholar

Gina Weisblat, Ph.D., has been designtated the 2017 Allan Wilke, MD National Conference Scholar

The 2016 National Conference Scholars

Andrea Clarke, MD, Kaiser Permanente Napa, has been designated the 2016 Jimmy H. Hara National Conference Scholar

Amy McGaha, MD, Creighton University, Omaha, has been designated the 2016 Perry A. Pugno National Conference Scholar

Dennis Means, MD, Kalamazoo Family Health Center, Kalamazoo, Michigan has been designated the 2016 Donald Frey National Conference Scholar

Thomas E. Norris, MD, University of Washington Emeritus, has been designated the 2016 John Geyman National Conference Scholar

Keosha Partlow, Ph.D., Charles R. Drew University, has been designated the 2016 Ana Bejinez-Eastman National Conference Scholar

Adalberto Renteria, MD, has been designated the 2016 Hector Flores National Conference Scholar

Devin Sawyer, MD, Providence Health Systems, Olympia, Washington, has been designated the 2016 Kevin Haughton National Conference Scholar

Sunny Smith, MD, University of California, San Diego, has been designated the 2016 William A. Norcross National Conference Scholar

Sarah Woolsey, MD, has been designated the 2016 James Herman National Conference Scholar

The 2015 National Conference Scholars

J. C. Buller, MD, Associate Dean, Touro University, Vallejo, California, has been designated the 2015 Rick Flinders National Conference Scholar

Maria T. Carriedo-Ceniceros, MD, Vice President and Chief Medical Officer, San Ysidro Health Center, San Ysidro, California, has been designated the Marianne McKennett National Conference Scholar

Emily Dow, MD, Acting Chair, Department of Family Medicine, University of California, Irvine, has been designated the 2015 Joseph E. Scherger National Conference Scholar

Stan Kozakowski, MD, American Academy of Family Physicians, has been designated the 2015 Norman B. Kahn, Jr National Conference Scholar.

Steven Pollens, has ben designated the 2015 Robert Ross National Conference Scholar

JuliusAngelo Ramirez, MD, Western Michigan University School of Medicine, Kalamazoo, has been designated the Allan Wilke National Conference Scholar

Janice Spalding, MD, Northeast Ohio College of Medicine, Rootstown, has been designated the 2015 F. Marian Bishop National Conference Scholar

The 2014 National Conference Scholars

Suzanne M. Allen, the University of Washington Vice Dean for Regional Affairs, based at the WWAMI program in Boise, Idaho, has been designated the 2014 Norman B. Kahn, Jr National Conference Scholar.

Eileen Chaing, CFO of the Family Health Center, Kalamazoo, Michigan, has been designed the 2014 Marianne McKennett National Conference Scholar.

Desiree Cox-Maksimov, MD of Eden Healthcare Consulting Ltd and the University of Exeter, United Kingdom, has been designated the 2014 Jimmy H. Hara National Conference Scholar.

Cheryl Dickson, MD, Associate Dean for Community Health and Health Equity has been designated the 2014 Robert Ross National Conference Scholar.

Walter Mills, MD, of Natividad Medical Center, Salinas, California, has been designated the 2014 Perry A. Pugno National Conference Scholar.

Caryn Slack, MD, of the Utah Department of Health, Medicaid Division, Salt Lake City, has been designated the Michael D. Prislin National Conference Scholar.

The 2013 National Conference Scholars

Michael Fine, MD, Director of Health, State of Rhode Island, has been designated to be the David N. Sundwall National Conference Scholar, named for the former Head of the Health Resources and Services Administration, United States Department of Health and Human Services.

Robert Bowman, MD, A. T. Still University School of Osteopathic Medicine or Arizona, has been designated the Mitchell Kasovac National Conference Scholar, named for an Emeritus Professor of the A. T. Still University SOMA.

Denise Crawford, of the Kalamazoo Family Health Center, has been designated the Virginia Fowkes National Conference Scholar, named for the Senior Research Scholar Emerita, Stanford University School of Medicine.

SONY DSC

Mark D. Goodman, MD of Creighton University School of Medicine, has been designated as the Gary F. LeRoy National Conference Scholar, named for the Associate Dean of Student Affairs and Admissions, Wright State University Boonshoft School of Medicine.

Colin Kopes-Kerr, MD of Peach Tree Health Care, Marysville, California, has been designated as the Perry A. Pugno National Conference Scholar, name for the Vice President, Education, of the American Academy of Family Physicians.

Colin Kopes-Kerr, MD (right), the 2013 Perry A. Pugno National Conference Scholar with Dr Pugno
Colin Kopes-Kerr, MD (right), the 2013 Perry A. Pugno National Conference Scholar with Dr Pugno

Carol Levitt, MD, of Generations Family Health Center, Danielson Connecticut, has been designated as the Cynthia G. Olsen National Conference Scholar, named after the Acting Chair of the Department of Family Medicine at Wright State University Boonshoft School of Medicine.

Eugenie Lewis, MHSA, LCSW, has been designated as the Allan Wilke National Conference Scholar, named after the Chair of the Department of Family and Community Medicine of Western Michigan University School of Medicine.

Carol Wilson Saffold, MD . of the Family Health Center, Kalamazoo, Michigan, has been designated the Ana Bejinez-Eastman National Conference Scholar, after the Associate Program Director, Family Medicine Residency, Presbyterian Intercommunity Hospital of Whittier, California

Elizabeth Schlegel, Ph.D., MBA, of the Ross University, Dominica, West Indies, has been designated the Marc E. Babitz National Conference Scholar, after the Director of the Division of Health Systems Improvement of the Utah Department of Health.

 The 2012 National Conference Scholars

David Squire, then a member of the Utah Medical Education Council, received the F. Marian Bishop Memorial National Conference Scholar position, named after the late Chair of the Department of Family and Preventive Medicine at the  University of Utah and President of both the Society of Teachers of Family Medicine and the Society of Teachers of Preventive Medicine.

Danielle Renaud, Ph.D., received the Thomas C. Brown Memorial National Conference position. Dr Brown was a major figure in the development of family medicine curricula in several California resident programs.

Sally Bachofer, MD, of the University of New Mexico, received the Charles Q. North National Conference Scholar position, named for the former clinical director of the United States Indian Health Service.

Benjamin Fredrick, MD, of Penn State University/Milton S. Hershey College of Medicine, received the Mark Clasen National Conference Scholar position, named for the emeritus Chair of Family Medicine at Wright State University, Dayton.

Frederick Schwartz, DO, of the A. T. Still College of Osteopathic Medicine, Mesa, Arizona, received the J. Jerry Rodos National Conference Scholar position, named for the former Dean of the Midwestern University College of Osteopathic Medicine.

Ramiro Zuniga, MD, of the San Joaquin General Hospital, French Camp (Stockton), California, received the John Geyman National Conference Scholar position, named for the Emeritus Chair of Family Medicine at the University of Washington.

 

Confirmed Faculty: The 28th National Conference on Primary Health Care Access

The following members of the permanent faculty of the National Conferences on Primary Health Care Access have confirmed their participation in the 28th National Conference, to be held April 10-12, 2017 at the Hyatt Regency New Orleans. 

The 28th National Conference Faculty:

A neighborhood in New Orleans' French Quarter
A neighborhood in New Orleans’ French Quarter

Suzanne M. Allen, MD, MPH, University of Washington WWAMI Program, Boise, Idaho

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

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

William H. Burnett, MA, Coastal Research Group, Granite Bay, California

Eileen Chiang, CMA, Family Health Center, Kalamazoo, Michigan

J. Scott Christman, MPDS, Office of Statewide Planning and Development, Sacramento, California

Mary T. Coleman, MD, Louisiana State University, New Orleans

Denise Crawford, EMBA, MSW, Family Health Center, Kalamazoo, Michigan

Delight F. Erickson, RNC, FNP, MPH, Radius Medicine Group, Andover, Minnesota

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

Rick Flinders, MD, Sutter Health, Santa Rosa, California

Donald Frey, MD, Creighton University, Omaha, Nebraska

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

Ivan Gomez MD, California Statewide Area Health Education Center, Fresno, California

Steven Harrison, MD, Natividad Medical Center, Salinas, California

James M. Herman, MD, MSPH, University of Oklahoma School of Community Medicine, Tulsa

Norman B. Kahn, Jr, MD, Council of Medical Specialty Societies, Chicago, Illinois

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

Samuel C. Matheny, MD, MPH, University of Kentucky, Lexington

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

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

Erik Porfeli, Ph.D., Northeast Ohio Medical University, Rootstown, Ohio

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

Emilio A. Russo, MD, Louisiana State University, New Orleans

Janice Spalding, MD Northeast Ohio Medical University, Rootstown, Ohio

Jeffrey Susman, MD, Northeast Ohio Medical University, Rootstown, Ohio

Daniel Webster, MD, Michigan State University Munson Health, Traverse City

Gina Weisblat, Ph.D., Northeast Ohio Medical University, Rootstown, Ohio

Allan J. Wilke, MD, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan

Teresa Zyrd, MD, Wright State University Boonshoft School of Medicine, Dayton, Ohio

University of Washington’s Vice-Dean Suzanne Adams to Give 24th Charles E. Odegaard Lecture Lecture at 28th National Conference on Primary Health Care Access

Suzanne Allen, MD; University of Washington WWAMI Program Boise, Idaho
Suzanne Allen, MD; Vice-Dean
University of Washington WWAMI Program
Boise, Idaho

Suzanne Adams, MD, MPH, University of Washington’s Vice-Dean for Academic, Rural and Regional Affairs, has been named the 24th Charles E. Odegaard Lecturer at the 28th National Conference on Primary Health Care Access.

The Lecture is scheduled for Wednesday, April 12th at the Hyatt Regency New Orleans.

At the University of Washington School of Medicine (UWSOM), Suzanne Allen works broadly across academic affairs and regional affairs to enhance the excellence of medical education for the UWSOM and the five-state WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region.

WWAMI started in 1971 and is accredited through the University of Washington School of Medicine and provides publically supported medical education for citizens of the participating states.  WWAMI students complete the classroom phase of the curriculum in their home state and then their required and elective clinical rotations may be completed at locations across the five-state region.

In addition to serving as the Vice Dean for Academic, Rural and Regional Affairs, Dr. Allen holds a Clinical Professor faculty position within the Department of Family Medicine at the University of Washington School of Medicine. Dr. Allen is an attending physician at the Family Medicine Residency of Idaho and an active physician in the Department of Family Medicine at Saint Alphonsus Regional Medical Center and Saint Luke’s Medical Center located in Boise, Idaho. Dr. Allen is committed to medical education and rural healthcare.

“Access”: Improving Health Care Access in California’s Central Valley, Part 1: Adventist Healthcare’s Service to the San Joaquin Valley

One the second and third days of the 28th National Conference on Primary Health Care Access (to be held April 10-12, 2017 at the Hyatt Regency New Orleans), the program will center on strategic initiatives, sponsored by health professions educational systems, mission-oriented healthcare institutions, state and local governments, and federal programs through the Department of Health and Human Services.

Such initiatives include long-term strategies to build a workforce and institutional base for effective primary health care systems in rural and underserved areas.

Adventist Health Systems’ Strategic Initiatives in Medically Underserved Areas

White Memorial Medical Center's service area, East Los Angeles, California
White Memorial Medical Center’s service area, East Los Angeles, California

Previous National Conferences have devoted several sessions to the success of the Adventist Health Systems efforts to establish a viable primary healthcare workforce in the Latino neighborhoods of East Los Angeles and Eastern Los Angeles County.

The cornerstone of these efforts is the White Memorial Medical Center Department of Family Medicine’s residency training program in family medicine, described by Hector Flores, MD, at the very first of the National Conference on Primary Health Care Access in April 1990 [see First National Conference on Primary Health Care Access (4th Plenary Panel, Part 2, Flores).

Adventist Medical Center, Hanford, California
Adventist Medical Center, Hanford, California

Another Adventist Health Systems’ initiative is the network of rural health clinics throughout the agricultural counties of the San Joaquin Valley, the Southern part of California’s Great Central Valley.

Such strategies are aimed at  improving access to care and physician recruitment and retention to better serve the communities in the Central Valley.

Derrick Gruen; Adventist Health Systems, Hanford, California
Derrick Gruen; Vice President
Adventist Health Systems Central Valley Region, Hanford, California

A presentation on this initiative will be made by the Regional Vice President, Derrick J. Gruen, PT, DPT, MALOS and the Medical Director, Adalberto Renteria, MD, for the Adventist Health Central Valley Region.

Their presentation will cover the challenges of delivering quality health care in a geographically dispersed rural health clinic system.

The Central Valley of California is one of the world’s most productive agricultural regions.

The counties that comprise it – including Kern, Kings, Tulare, Fresno and Madera Counties – have historically suffered chronic shortages of physicians, in both primary and specialty care.

Adalberto Renteria, MD; Medical Director, Adventist Health Systems
Adalberto Renteria, MD;
Medical Director, Adventist Health Systems Central Valley Region, Hanford, California

Medicaid patients and those who “self pay” include a high proportion of agricultural farmworkers and their families, have had to be referred to the distant cities of Los Angeles and San Francisco for specialty care.

The Adventist Healthcare Systems’ initial commitment to the Central Valley dates from 1993. By 2005 the organization was operating 18 licensed healthcare clinics.

Dr. Gruen oversees multiple departments across  including Adventist Health Community Care Clinics (Rural Health).

His responsibilities also include Physician Recruitment and Retention, and oversight of the Adventist Health Systems’ “Physician 1206L Foundation Clinics” a special category of hospital-affiliated community-based multispecialty practices established by California law.

The Community Care Clinics are a network of 36 licensed rural health clinics with 160+ physician partners, covering a service area of 4000 square miles, providing a safety net to the underserved in the Central Valley of California. It is the largest hospital-based rural health clinic system in California and the second largest in the nation. 

Dr Renteria serves as the Adventist Health Systems Regional Medical Director for Central California. HImself the product of a family engaged in agriculture (he has personal experience in grape harvesting, while his father’s long career was devoted to vineyard management in the Napa Valley), Dr Renteria has insight into farmworker’s health and social needs and rapport with the farmworker families that the Adventist rural clinics serve.

The National Conferences are invitational. For information on the invitation process, contact William H. Burnett at [email protected]

 

Dean James Herman to Give 27th G. Gayle Stephens Address at 28th National Conference on Primary Health Care Access

James Herman, MD, MSPH, Dean, University of Oklahoma/Tulsa University School of Community Medicine; Tulsa
James Herman, MD, MSPH, Dean, University of Oklahoma/Tulsa University School of Community Medicine; Tulsa

James Herman, MD, MSPH, the Dean of the Uiniversity of Oklahoma/Tulsa University School of Community Medicine, Tulsa, has been named the 27th G. Gayle Stephens Lecturer at the 28th National Conference on Primary Health Care Access. The Lecture is scheduled for Tuesday April 11, 2017 at the Hyatt Regency New Orleans.

Doctor Herman was previously Associate Dean for Primary Care and Department Chair of Family and Community Medicine at the Penn State University/Milton B. Hershey School of Medicine in Hershey, Pennsylvania, where he headed the Pennsylvania Area Health Education program.

The Tulsa School of Community Medicine, whose commitment to community-oriented primary care has been noted in previous sessions of the National Conferences, is in the process of expanding to a four-year medical school.

The Stephens Lectures are named after the late G. Gayle Stephens, MD, a noted author and pioneer of the resurgence of family medicine and primary care in the United States.

Dr Stephens presented the first Stephens Lecture, which became famously known as the “Big Red Bull” speech, because its use of a metaphorical image of the American system of medical care [Proceedings of the Second National Conference: The First G. Gayle Stephens Lecture by G. Gayle Stephens, MD.]

Later Stephens Lecturers have included many prominent figures in American medical education, including the late Charles E. Odegaard of the University of Washington,  F. Marian Bishop of the University of Utah, and Lynn Carmichael of the University of Miami.

28th National Conference: Dr Donald Frey Presents “Physician Workforce—An Issue of Medical Ethics as well as National Priority”

Donald Frey, MD; Creighton University, Omaha, Nebraska
Donald Frey, MD; Creighton University, Omaha, Nebraska

On the first morning of the 28th National Conference on Primary Health Care Access, Creighton University’s Doctor Donald R, Frey will present a Thought Provocateur session entitled “Physician Workforce—An Issue of Medical Ethics as well as National Priority”.

At Creighton University, a Jesuit institution based in Omaha, Nebraska, Doctor Frey has held the Dr Roland L Kleeburger Endowed Chair since 1996.

As Creighton University’s Vice President for Health Sciences, Dr Frey is responsible for the oversight of Creighton’s schools of dentistry, medicine, nursing, and pharmacy and health professions. He has had long service at Creighton as Chair of the university’s Department of Family Medicine, preceded by the Directorship of the Family Medicine Residency Program.

Doctor Frey will discuss the American way of funding physician education. For the past half century, the major source of federal funding for medical education are the “direct” and “indirect” graduate medical education funds appropriated through the Medicare budget, currently administered by the Centers for Medicare and Medicaid Services.

These funds are distributed to eligible hospitals with physician residency positions by means of formulas that become increasingly complex over the decades, with major modifications of the program included within the Patient Protection and Affordable Care Act (ACA).

The provision of high quality health services throughout the nation requires a physician workforce sensitive to the needs to all the nation’s geographical areas and populations. The challenges, dangers and opportunities that face the nation’s postgraduate medical training (i.e., physician residency positions and fellowships) will be the subject of Dr Frey’s Thought Provocateur session.

 

 

Norman B. Kahn, Jr., MD to Give 23rd J. Jerry Rodos Lecture April 10, 2017 at 28th National Conference on Primary Health Care Access

Norman B. Kahn, Jr, MD Council of Medical Specialty Societies, Chicago
Norman B. Kahn, Jr, MD
Council of Medical Specialty Societies, Chicago

Doctor Norman B. Kahn, Jr., the Executive Vice-President of the Council of Medical Specialty Societies, will present the 23rd J. Jerry Rodos Lecture on Monday April 10, 2017, the first morning of the 28th National Conference on Primary Health Care Access.

The academic and professional career of Doctor Kahn, a Senior Fellow of the National Conferences on Primary Health Care Access, brings him unparalleled insights into issues of access in the United States health system.

Dr Kahn was one of the residency classes for the new specialty of family medicine, training in the early 1970s at University of California San Francisco community-based public hospital, San Francisco General, thereby gaining professional experience in caring for San Francisco’s multicultural, diverse-lifestyle population.

Within a few years of his graduation, he was appointed family medicine residency director for Stanislaus County’s Scenic General Hospital, in the heart of California’s Central Valley, one of the nation’s major agricultural regions. Dr Kahn oversaw the Scenic residency program’s establishment of a community health center in the small, agricultural town of Hughson, one of the early experiments in teaching family medicine residents to provide care in a community health center setting.

Doctor Kahn subsequently replaced Doctor John Geyman (also a Senior Fellow of the National Conferences) in the role of administrator of the University of California Davis’ Network of Affiliated Residency Programs. From that position he was invited to join the executive staff of the American Academy of Family Physicians in Kansas City, Missouri, where he served Executive Vice President for education.

Dr Kahn was a strong advocate for cooperative activities between the primary care medical specialties, and, later, for cooperative activities for all of the medical specialties. These ideas were incorporated into the Council of Medical Specialty Societies, an institution which he has served as Executive Vice President.

 

 

 

28th National Conference on Primary Health Care Access: Charles Q. North, MD and Jeremy Fish, MD: “Assessing Access to a Primary Health Safety Net”

north-300On Monday, April 10, 2017, the first day of the 28th National Conference on Primary Health Care Access, the first plenary panel will follow individual presentations by Doctors David Sundwall and John Geyman, relating to the status of the Affordable Care Act.

The first plenary panel will be comprised of Charles Q. North, MD, MS of the University of New Mexico and Jeremy Fish, MD of the Contra Costa County Medical Services in Martinez, California.

Doctor North’s Presentation

Doctor North, a Senior Fellow of the National Conferences on Primary Health Care Access, served as a career officer in the United States Indian Health Service.

In a “Great Debate” about whether the Patient Protection and Affordable Care Act [ACA] could be considered a success that took place in the 26th National Conference in 2015, Doctor North took the opposition position [see Time Will Tell”: the Proceedings of the 26th National Conference – The Great Debate: Obamacare has been a Great Success, Part 2 (North for the Negative)]

Dr North argues that the debate about how health care should be financed has obscured the debate about how the delivery system should be reformed to assure access to comprehensive, continuous health care that recognizes the importance of community-oriented medicine, and public health and its social determinants.

He has found that many of his patients, who previously had had access to most of the health services they needed through the Bernalillo County-financed health care system based in Albuquerque, have since the passage of ACA, found themselves assigned to prohibitively expensive insurance plans with narrow provider networks that do not meet their needs.

A fundamental error in Obamacare has been the imperative of enrolling patients in insurance plans that are basically designed as “risk pools” whose fees are priced to cover the expenditures required for the  health care needs of all the persons covered in the plans.

Yet, when very sick people, whose care may previously have been subsidized by government funds, sign up for a given plan, the costs of care to the very sick are shifted from “taxpayers in general” to the specific persons enrolled in the plan. The increase in costs shouldered by the plan’s recipients, it can be argued, are not the fault of sick persons who were seeking ways to manage their health care costs coverage, but are the result in defects in the legislation.

Before enactment of the ACA, the health care costs of many “uninsured” persons were absorbed by various publically-financed programs, most of which continue to function, but, for some programs in some states and communities, are partly channeled through the health care plans.

Currently, the federal government re-insures the private insurance companies by paying for catastrophes through government insurance (Medicare, Medicaid, the Indian Health Service [IHS], the Veterans Administration [VA], the Department of Defense [DOD], End Stage Renal Disease [ESRD], Ryan White, etc.) and by subsidizing local hospitals through trauma care support and other disease specific schemes (Breast and Cervical Cancer screening program.)  These are all “work arounds” that avoid the appearance of the taxpayer paying for re-insurance and to allow for a private for-profit insurance industry to survive.

Doctor Fish’s Presentation

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

Doctor Fish is the founding family medicine residency program director at a new residency program based John Muir Health, in Walnut Creek.

Previously, Dr Fish served as the residency director for the health system for California’s Contra Costa County, one of the early leaders in the creation of comprehensive county-financed health services. The Contra Costa County family residency program is part of a unique Registrar model for training traditional full-spectrum family physicians.

The new John Muir program will open in June 2017 and will focus on a clinic-first, new model full-spectrum family medicine, that will include the local population of all ages, genders and conditions (a feature of most family medicine programs, and all payer residency practice, which is planned to serve 50% Medicaid, with the goal of providing seamless care across the payer spectrum.

The residency program’s primary purpose is to develop graduates to “joyfully provide comprehensive Family Teamcare”, including common office procedures.

Dr Fish describes himself as passionate for the all-payer aspect. He argues that the multi-payer, single payment model should be the next step beyond ACA, since he believes that we are likely decades away from a single payer financing system

Dr Fish intends to highlight what is precious to primary care medicine in ACA that must be preserved, and what are the opportunities might exist for legislative improvements to strengthen primary care.

ACA’s commitment to assuring health care for all should continue as a national priority, whatever revisions might be made to its legislative format.

The ACA includes features that, fully implemented as originally envisioned, should improve the quality of the health care system.

Strategic Initiatives to Promote Access

The panel will introduce one of the themes that will continue through the plenary sessions of the three National Conference days – an examination and celebration of strategic initiatives that have proven successful models of entities that provide and enhance access to comprehensive primary health care.

These thematic presentations will include discussion of community-oriented health centers, community-based primary care physician residency programs, Area Health Education Centers, and teaching health centers.

28th National Conference – John Geyman MD on Health Care Reform 2017: What are our Options Now?

John Geyman, MD
John Geyman, MD

Doctor John Geyman’s insightful analyses of what he believes are the fundamental errors in the Patient Protection and Accountable Care Act [ACA] have been highlights of the National Conference on Primary Health Care Access over the past half decade.

Dr Geyman returns as a featured speaker at the 28th National Conference on Primary Health Care Access, to be held April 10-12, 2017 at the Hyatt Regency New Orleans.

A prolific author on health care policy, Dr Geyman’s latest book, Crisis in U. S. Health Care: Corporate Power vs the Common Good is scheduled for release in early Spring. The book will incorporate (as will Dr Geyman’s presentation in New Orleans) Dr Geyman’s analysis on the new Administration’s proposals for revising ACA and other federal health priorities.

Dr Geyman’s presentation will take place on Monday morning April 10th.

Dr Geyman will be joined by a reactor panel enlisted from the permanent faculty of the National Conferences on Primary Health Care Access.

The National Conferences are invitational, and consist of approximately four to five dozen drawn from experts on health care policy, public health, community health centers and teaching health center projects, and academic health sciences center faculty. The National Conferences are conducted by the Coastal Research Group, a 501c-3 non-profit corporation devoted to healthcare workforce issues.

For information on the invitation process, contact William H. Burnett, Coordinator of the National Conferences at [email protected]