Family ties: AAFP's EVP lauds family-oriented care

DOUGLAS E. HENLEY, MD, BELIEVES that the U.S. healthcare system is so fragmented, so disjointed and so disorganized that he finds it hard to even refer to it as a system.

"I'm hesitant to use the word 'system' because it implies a certain degree of organization, and healthcare in this country just isn't organized at all," says Dr. Henley, 56, the executive vice president of the American Academy of Family Physicians (AAFP). "We need a focused, family-oriented and personalized brand of medicine today more than ever."

Q. In your own words, what is "family medicine" and what does it mean for patients today?

A. Many people now have a lack of recognition of what family medicine is and what the AAFP stands for. Family medicine is about providing care to individuals in the context of their own family, their workplace and their community. It also provides the very important integration of many care factors and venues that will give patients the best medical care possible.

There is a huge body of evidence in medical literature clearly showing that with patients who have greater access to primary-care physicians, the quality of care goes up and the cost of care goes down. Most conditions in medicine today are fairly common; statistics show that of 1,000 patients treated in any given month, only eight of them wind up in a hospital and only one winds up in an academic medical center-where specialists practice and train-to receive their care. Yet the focus is less on family medicine than institutional medicine, at least as far as our healthcare system perceives things.

Q. How has family medicine changed over the past couple of decades?

A. It's changed in two significant ways. First, the concept of family has changed-it's not the nuclear-family concept it once was years ago. For instance, grandparents and extended-family members take care of children more than ever. How we care for a person within the context of this redefined family, however, hasn't changed.

Q. The AAFP's stated vision is "to transform healthcare to achieve optimal health for everyone." What needs to be transformed, and how will the transformation happen?

A. We think the healthcare 'system' needs to be thrown on its head and reorganized. We simply need to get people back to more personal primary care-that should be the focus of everything in healthcare. At the same time, everyone in this country deserves some level of healthcare, and obviously that isn't happening. Healthcare services and healthcare coverage for everyone is needed-and needed badly.