The U.S. healthcare system is "financially unsustainable" and must be reformed, said the incoming president of the American Academy of Family Physicians in a speech that set an energetic tone for the organization's 2008 annual conference, which began Wednesday.
Ted Epperly, MD, excited attendees at the opening session of the AAFP's Annual Scientific Assembly in San Diego with strident critiques of healthcare as currently structured in the United States, terming it a "sick care system that places more value on treating disease than on wellness and the prevention of disease."
Epperly, an Idaho physician taking over the AAFP presidency from Jim King, MD, said healthcare in the United States is a "$2.3 trillion medical-industrial complex" that isn't centered on the patient and could not long survive in its present form.
But he acknowledged that hope for change did exist, because most industry observers recognize that the status quo is untenable.
"Because the current system is unsustainable, I have never seen it more fluid and moldable than it is now," Epperly said. "There is a real opportunity for change."
Epperly emphasized that a new physician payment system would have to be at the heart of systemic transformation, as a career in family practice is difficult for physicians to maintain given the continual cuts in reimbursement. The AAFP has called for a "blended payment system" that would offer incentives for quality of care improvements as well as payments for alternative physician-patient encounters, such as e-visits.
A transformed healthcare system should be organized around the "patient-centered medical home" model, Epperly said. He suggested that the domination of U.S. medicine by "subspecialization" had contributed to a decline in the quality of patient care, as well as a distorted system of physician reimbursement.
"We need workforce reform in American medicine," Epperly said. "We need to increase the number of family practice physicians 39 percent by 2020."
The new AAFP leader also called on his colleagues to remind their political representatives and fellow citizens that they need to build "a healthcare system for all" in the United States, not just for those who can afford to pay for care.
The two keynote speakers following Epperly echoed his critique of contemporary U.S. healthcare.
Terry McAuliffe, the former Democratic Party chairman, and John Kasich, a former Ohio Congressman and chairman of the House Budget Committee, agreed that the United States needs to encourage preventive care and reform the physician reimbursement system.
"Primary care and wellness should be our focus," said McAuliffe. He predicted that "reform will come next year," regardless of who wins the presidential election.