Current Policies | Structures and Definitions
CHAPTER AND NATIONAL POLICY RELATIONS
Unless otherwise stipulated in separate PAFP Policy, the PAFP accepts current AAFP policy regarding issues facing our members, our patients, and our specialty.
The PAFP opposes legislation or executive action that would require mandatory education of family physicians as a condition for prescribing specific drugs, diagnosing specific diseases, or treating specific patient populations, behaviors or illnesses above and beyond that mandated by physician specialty boards.
The American Academy of Family Physicians (AAFP) believes prior authorizations should be standardized and universally electronic throughout the industry to promote conformity and reduce administrative burdens. Prior authorizations create significant barriers for family physicians to deliver timely and evidenced-based care to patients by delaying the start or continuation of necessary treatment. The very manual, time-consuming processes used in prior authorization programs burden family physicians, divert valuable resources away from direct patient care, and can inadvertently lead to negative patient outcomes.
The AAFP believes family physicians using appropriate clinical knowledge, training, and experience should be able to prescribe and/or order without being subjected to prior authorizations. In rare circumstances when prior authorizations are clinically relevant, the AAFP believes they should be evidenced-based, transparent, and efficient to ensure timely access and ideal patient outcomes. Additionally, family physicians that contract with health plans to participate in a financial risk-sharing agreement should be exempt from prior authorizations.
The AAFP believes that generic medications should not require prior authorization. The AAFP further believes step therapy protocols used in prior authorization programs delay access to treatments and hinder adherence. Therefore, the AAFP maintains that step therapy should not be mandatory for patients already on a course of treatment. Ongoing care should continue while prior authorization approvals or step therapy overrides are obtained. Patients should not be required to repeat or retry step therapy protocols failed under previous benefit plans.
STUDENT CHOICE FOR FAMILY MEDICINE
The Academy affirms the AAFP policies on Student Choice of Family Medicine, Incentives for Increasing. In addition, the Academy will continue to directly support PA medical students pursuing Family Medicine in multiple ways, including but not limited to: leadership within the student assembly, mentorship, scholarships to attend National Conference, leadership development, opportunities to present research, and support for Family Medicine Interest Groups.
The PAFP supports legislation that provides for regulation of indoor tanning facilities in the Commonwealth, which includes the protection of children.
Download a PDF of PAFP policies (updated Jan. 2018)
Structures and Definitions
PAFP AND PAFP/F STRUCTURE
The PAFP is unified with the American Academy of Family Physicians (AAFP). Members of the PAFP are automatically members of the AAFP, and vice versa.
The PAFP’s Executive Committee includes the President, President-Elect, Treasurer, Immediate Past President, and the Executive Vice President (CEO).
Commissions (standing task forces), the PAFP Board of Directors and PAFP/F Board of Trustees meet two weekends a year at what is commonly called "Cluster." Each commission meets individually and then reports to the Board of Directors. The Public Policy Commission usually kicks off these meetings with an evening meeting on the Thursday of spring Cluster and Friday of fall Cluster. It's held separately because it typically lasts longer and has more attendees than any other commission. Other commissions currently include Practice Advocacy, Planning, Member Services, Student and Resident Affairs and Finance. PAFP and PAFP/F meetings are open to all members.
PAFP assemblies include the Student Assembly, Resident Assembly and Assembly of Family Practice Residency Program Directors and Family Practice Department Chairs. Each year, elections are held to appoint leaders to best represent the individual constituencies for the coming year at both state and national conferences. The assemblies also submit resolutions to be considered at the Annual Business Meeting, held in concert with spring Cluster.
All committees, commissions and assemblies are staffed by at least one PAFP employee to serve the needs of that particular group.
Annual Business Meeting
The all-member Annual Business Meeting convenes once a year at a CME (continuing medical education) event.
Town Hall meetings are held at each CME conference event to give members a chance to ask questions and make comments to board members and other physician leaders.
PAFP board members serve as the PAFP Foundation Board of Trustees.
DEFINITIONS OF FAMILY MEDICINE
The following definition adopted by the 1975 Congress of Delegates is the AAFP's official definition of a family physician: The family physician provides health care in the disciplines of family practice. His/her training and experience qualify him/her to practice in the fields of medicine and surgery. The family physician is educated and trained to develop and bring to bear in practice unique attitudes and skills which qualify him/her to provide continuing, comprehensive health maintenance and medical care to the entire family regardless of sex, age or type of problem, be it biological, behavioral or social. This physician serves as the patient's or family's advocate in all health-related matters, including the appropriate use of consultants and community resources.
The following definition adopted by the 1986 Congress of Delegates is the AAFP's official definition of family practice: Family practice is the medical specialty which provides continuing and comprehensive health care for the individual and the family. It is the specialty in breadth which integrates the biological, clinical and behavioral sciences. The scope of family practice encompasses all ages, both sexes, each organ system and every disease entity. Family practice is the continuing and current expression of the historical medical practitioner and is uniquely defined within the family context.
In defining primary care, it is necessary to describe the nature of services provided to patients, as well as to identify the primary care providers. The domain of primary care includes the primary care physician*, other physicians who include some primary care services in their practices, and some non-physician providers. However, central to the concept of primary care is the patient. Therefore, such definitions are incomplete without including a description of the primary care practice.
The following four definitions relating to primary care should be taken together. They describe the care provided to the patient, the system of providing such care, the types of physicians whose role in the system is to provide primary care, and the role of other physicians, and non-physicians, in providing such care. Taken together they form a framework within which patients will have access to efficient and effective primary care services of the highest quality.
*The term "physician" refers only to doctors of medicine (MD) and osteopathy (DO).
1. Primary Care
Primary care is that care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the "undifferentiated" patient) not limited by problem origin (biological, behavioral, or social), organ system, gender, or diagnosis.
Primary care includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.). Primary care is performed and managed by a personal physician, utilizing other health professionals consultation and/or referral as appropriate.
2. Primary Care Practice
A primary care practice serves as the patient's first point of entry into the health care system and as the continuing focal point for all needed health care services. Primary care practices provide patients with ready access to their own personal physician, or to an established back-up physician when the primary physician is not available.
Primary care practices provide health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.).
Primary care practices are organized to meet the needs of patients with undifferentiated problems, with the vast majority of patient concerns and needs being cared for in the primary care practice itself. Primary care practices are generally located in the community of the patients, thereby facilitating access to health care while maintaining a wide variety of specialty and institutional consultative and referral relationships for specific care needs. The structure of the primary care practice may include a team of physicians and non-physician health professionals.
3. Primary Care Physician
A primary care physician is a generalist physician who provides definitive care to the undifferentiated patient at the point of first contact and takes continuing responsibility for providing the patient's care. Such a physician must be specifically trained to provide primary care services.
Primary care physicians devote the majority of their practice to providing primary care services to a defined population of patients. The style of primary care practice is such that the personal primary care physician serves as the entry point for substantially all of the patient's medical and health care needs-not limited by problem origin, organ system, gender or diagnosis. Primary care physicians are advocates for the patient in coordinating the use of the entire health care system to benefit the patient.
4. Limited Primary Care Providers
Individuals who are not trained in the primary care specialties of family medicine, general internal medicine, or general pediatrics will sometimes provide limited patient care services within the domain of primary care. These limited primary care providers may be physicians from non-primary care specialties. Such providers may also include nurse practitioners, physician assistants, or other health care providers. Limited primary care providers may focus on specific patient care needs related to prevention, health maintenance, acute care, chronic care or rehabilitation. The contributions of limited primary care providers may be important to specific patient needs. However, the absence of a full scope of training in primary care requires that these individuals work in close consultation with fully trained primary care physicians. An effective system of primary care may use limited primary care providers as members of the health care team with a primary care physician maintaining responsibility for the function of the health care team and the comprehensive health care of each patient.