President's Message
April 2024

Ron Adler, MD

Good afternoon.  On behalf of the Board of Directors and the entire membership of the Massachusetts Academy of Family Physicians, I would like to thank Dr. Biederman and Dr. Chin for your exceptional work this past year.

I feel honored and privileged to serve as president of our Academy.  I joined the Academy as a resident in 1989, and I have seen a lot of change since then.  But I have also seen what has endured through all the changes: commitment to serving our patients – especially the most vulnerable, commitment to evidence-based medicine and developing our craft with ever-expanding skill sets, and commitment to our learners.

As I step into this role, I am aware of multiple important factors:

First, I do not serve alone: we have a very talented and diverse leadership team with incredible breadth and depth of experience.  It was truly inspiring at our board meeting last evening to hear the extraordinary journeys that each of you have taken.  Your lived experience – professional and personal – will help us identify the best paths forward for our Academy.  Part of what was so special in hearing your diverse stories were the unifying themes that came up repeatedly and the values that we all share: primarily service to our patients and our learners.

Second, while our leadership team is excellent, ultimately, the strength of our Academy lies among those of you out there. You are serving your patients, teaching our learners, and many of you are the students and residents who represent the future of Family Medicine in Massachusetts. I appreciate that your plates are already full, but I also know it is your energy, intelligence, wisdom, creativity, and passion that can drive us forward to accomplish great things.  We need your participation.

Third, we are facing a potential crisis in Family Medicine and primary care. This is the result of many factors, including administrative burden, burnout, financial pressures, and the many entities that have entered healthcare with a focus on making money, not serving the interests of our patients.

I am a firm believer in the idea that in crisis, there is opportunity, and we need to meet these challenges head on. Family Medicine is the answer to so many of the problems in US healthcare today. Where Family Medicine is robust, the quality of care is better, the cost of care is lower, and there is greater equity in the delivery and experience of healthcare. 

Our challenge is to help the powers that be appreciate that, and we need to find ways to speak in a strong and unified voice, advocating for our patients and the citizens of the Commonwealth.  This also means advocating for changes that will ensure that Family Medicine thrives for years to come.  We need people to see that Family Medicine is foundational to a high-functioning health care system – and without us, the system is at risk of devolving into even lower value and unsustainably high cost.  I believe that – with your help – our Academy can be a key driver of the changes we need.

Among Family Physicians these days, there is a lot of discussion of burnout and moral injury: the idea that bad things happen when people are pressured to do things that run counter to their values.  Rather than facilitating our work, our healthcare delivery systems often create barriers and require wasteful activities that sap our good energy, causing us to waste time, effort, and resources, doing things that do not advance health and well-being.

The challenges we face in meeting the needs of our patients are both daunting and growing.  We had hoped that in an age of Information Science -- and now AI -- the job could get easier, but sadly, most days, the opposite seems true.

I challenge us, however, to keep our eyes on the prize and remember why we became family physicians.

While menial tasks can distract us and drag us down, there are many times throughout the day when the work we do fulfills our altruistic and idealistic aspirations. Seeing the baby of the baby you delivered 20-something years ago. Hearing the gratitude expressed by your patient because the colposcopy you just performed was so easy for her compared to what she anticipated.  Appreciating that your 82 yo patient feels comfortable enough – in fact, compelled -- to share with you the abuse he suffered as an 11-year-old.  Initiating prenatal care for the patient who is forever loyal to you because you HEARD her symptoms 6 years ago and diagnosed her multiple sclerosis.  Remembering your patient when he was a rambunctious adolescent whom his mother struggled to reign in -- as he steps up to care for her because she is now developing dementia.  Receiving a hug from your patient – whose babies you delivered – because she appreciates that you understand why she doesn’t want to participate in treatment trials at Dana Farber for her metastatic cancer.

Is this a job?  A calling?  For me: it’s a privilege!

These moments, especially when we pause to recognize and share them, can refill our buckets, sustaining us with purpose and meaning. 

Yes, the system clearly needs to be fixed, and I remain hopeful that we can muster the power to influence positive change by speaking in a unified, collective voice.  Our legislative initiatives are pushing for this, but that is a slow process.

My suggestion in the meantime is that as individuals, we cultivate the joy we can find in meaningful moments with our patients and learners. THIS is something that is within our control every day.  And I hope we all can find it and share it.

When we remain connected to our deeply held personal values, to our purpose and the work that provides meaning in our lives, we can be fulfilled and happy despite some of the nuisance factors we may experience in practice.  This is what can shield us from burnout.

While there have been many advances in health care over the years -- with the possible exception of vaccines -- there has never been anything ever created that is as impactful as a Family Physician providing evidence-based, patient-centered care to families – care that is firmly grounded in the relationship between physician and patient.

Take pride in your identity as a Family Physician, and let’s unify around the core values that we treasure.

-Ron Adler, MD