The 2013 Congress of Delegates went to bat for the future of family medicine Sept. 24, adopting one resolution intended to help bolster the primary care workforce by shoring up the physician pipeline and calling for further study of another. A third measure seeking to survey family medicine residents about their medical school experience also was adopted.

Kansas alternate delegate Michael Kennedy, M.D., dean for rural health education at the University of Kansas, tells reference committee members that only about 5 percent of internal medicine residents and 11 percent of pediatrics residents that graduate from his program actually end up practicing primary care.

Although it seems clear that the number of primary care physicians medical schools indicate they're producing does not line up with the actual number who end up in primary care practice, it can be difficult to discern why. One resolution discussed during the Sept. 23 hearing of the AAFP Reference Committee on Education sought to address that problem by tying graduate medical education (GME) reimbursement and medical school accreditation to a minimum percentage of graduates selecting primary care.

Minnesota delegate Lynne Marie Lillie, M.D., of Woodbury, testified in favor of the resolution.

"As the funding for graduate medical education is going to become a very significant issue for America going forward with the (Patient Protection and) Affordable Care Act, simply increasing funding for primary care internal medicine residencies that only put 5 percent of their residents into primary care won't meet the big picture goal that we're trying to obtain," she said.

Although he agreed with the spirit of the resolution, said Missouri delegate Lawrence Rues, M.D., of Kansas City, he acknowledged he was uncomfortable with accreditation being part of the package.

The AAFP can't force the accreditation issue, which is the purview of the Liaison Committee on Medical Education, he said. "I would, however, say (to schools), 'Good, do your own thing, but you're not going to get as much money.'

"The public needs primary care and as ([then] AAFP President) Jeff Cain said, we need to prioritize GME funding to the needs of the public, because that's going to move things."

The resolution eventually was referred to the AAFP Board of Directors to work out details and coordinate with the AAFP's current advocacy efforts in regard to GME funding.

The reference committee also heard extensive testimony in support of a resolution asking the AAFP to request that

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AAFP Delegates Debate Workforce Pipeline, Other Education Issues