The Dual Role of Family Physicians

By Sarah C Ledger, DO, FAAFP

This article first appeared in the The Iowa Family Physician

It has been my honor to serve on your IAFP board for the past eight years as a director, then Vice President, President-Elect, and now your Academy President.

Over the years, we’ve navigated many transitions, and I am proud of all we have accomplished together. Your board and staff work tirelessly to provide you with the highest quality educational opportunities, the best advocacy for family medicine, and the support you need to thrive in your careers. Becoming an active member of the Academy has enabled me to engage more deeply with the broader dimensions of family medicine —through advocacy,
education, and member engagement.

 Sonia, our executive vice president, has  been with us for over a year now. Her hard work and innovative ideas have been transformative for our organization. Our staff members, Kelly and Katie have dedicated years to this organization. l’d like to express my gratitude to these three women who truly are the backbone of the lowa Academy.

 I grew up outside Fairfield, Iowa, a small town in the southeast corner of the state. I stayed in lowa for college at Loras in Dubuque,then attended Des Moines University for medical school. Although I spent some time on the East Coast for rotations, I ultimately returned to lowa for my residency at the lowa Lutheran program in Des Moines. I have been a physician owner at Family Medicine of Mt Pleasant for over 14 years. I have three beautiful children- Isabella, Emersen, and Brecken. At my independent practice, I have 4 physician partners, and we employ 5 physician assistants. We provide physician-led team-based care. My initial attraction to this clinic was its independence. Yes, we are still out there!

Family medicine is the cornerstone of comprehensive healthcare, dedicated to providing continuous and holistic care for individuals and families across all ages, genders, diseases, and parts of the body. Family physicians are uniquely positioned to understand patients within the context of their community and family life, advocating for personalized and patient-centered care that promotes overall well-being.

We must ask ourselves: when did healthcare become just a business? When did family physicians become replaceable cogs in a wheel, pushed by administrators? In my opinion, this shift towards corporatization has been one of the greatest failures of our healthcare system. Large systems have taken over, making decisions based on profit rather than patient care. Did you know that in the U.S., there are approximately 10 healthcare administrators for every physician? Healthcare administration has grown exponentially, while the number of physicians has remained stagnant and, in many areas, declined.

Who better to lead healthcare than physicians themselves? None of us went to medical school solely for financial gain and corporate greed. We endured long hours, the weight of student loans, and the stresses of this profession because we care deeply about healthcare, our patients, and our communities. I am excited to finally witness a growing trend of physicians
stepping away from larger systems and embracing independent practice. Physicians in independent practice tend to be more satisfied with their jobs, more connected
with their communities, and driven by patient-centered values.

 Of course, independent practices face  significant challenges today-insurance credentialing, payment hurdles, and competition from larger health systems, to name a few. The COVID-19 pandemic only deepened many of these challenges. I am fortunate to have practice partners with whom I have trusting relationships. My group has a guiding principle that we live by: “Base your decisions on what is best for the patient, and your business will follow.”

This simple approach has sustained our independent practice, even during the pandemic.

Throughout the next year, I would like to foster growth, collaboration, and education around independent practice styles in medicine. I want to educate residents and students early on about this practice style.

I plan to create a network or platform of communication for independent practices to share innovative ideas, challenges, and solutions. If we work together, we can learn from and support each other’s success. I want to advocate for the smaller independent practices, who don’t always have a strong voice in the legislature. If you want to join us in advocacy, please reach out to me or your Academy. Family physicians should be encouraged to take back the practice of medicine. Let’s ensure that healthcare is for our patients, not for corporations.

In closing, I’ll leave you with some words of wisdom from Shawn Martin- our wise AAFP Executive Vice President: “While the world around us may be uncertain, trust in you, our country’s family physicians, is not. People in communities across the country will be counting on you.

Because the relationships between you and your patients transcend current events, and they most certainly transcend politics. What you do matters. Family medicine matters.”