{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/vt1gh9dj93/manifest","type":"Manifest","label":{"en":["Dr. Jane Weida"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Description"]},"value":{"en":["\u003cp\u003eDr. Weida has been involved on many different boards, associations, and medical groups so she speaks about her time with those organizations. She says that through her time on a various number of Boards, she is able to effectively communicate will lots of different kinds of people and solve a wide range of problems. In her academic years she speaks about the gap that she took between her Master’s degree and going back for her M.D. The grants she received were used to work on innovations in medical education so that future physicians can be even more well prepared. Additionally, she had been part of the AAFP Foundation at the time of FMAH’s inception and she was able to become a Board member with FMAH. Like many other doctors, Dr. Weida believes there are many challenges, obstacles, and set backs in medicine right now and she hopes that positive policies are enacted for the future, like a better payment system for doctors and patients.\u003c/p\u003e (summary)"]}},{"label":{"en":["Date"]},"value":{"en":["2018-08-29 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Dr. Herbert Young (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","family physician","American Academy of Family Physicians"]}},{"label":{"en":["Subject"]},"value":{"en":["Jane Weida, MD (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["english (primary)"]}}],"summary":{"en":["\u003cp\u003eDr. Weida has been involved on many different boards, associations, and medical groups so she speaks about her time with those organizations. She says that through her time on a various number of Boards, she is able to effectively communicate will lots of different kinds of people and solve a wide range of problems. In her academic years she speaks about the gap that she took between her Master\u0026rsquo;s degree and going back for her M.D. The grants she received were used to work on innovations in medical education so that future physicians can be even more well prepared. Additionally, she had been part of the AAFP Foundation at the time of FMAH\u0026rsquo;s inception and she was able to become a Board member with FMAH. Like many other doctors, Dr. Weida believes there are many challenges, obstacles, and set backs in medicine right now and she hopes that positive policies are enacted for the future, like a better payment system for doctors and patients.\u003c/p\u003e"]},"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295058","type":"Canvas","label":{"en":["Media File 1 of 2 - WeidaJane_01_Access.mp3"]},"duration":1771.8768,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295058/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295058/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/295/058/original/WeidaJane_01_Access.mp3?1760553896","type":"Audio","format":"audio/mpeg","duration":1771.8768,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295058","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295058/transcript/85356","type":"AnnotationPage","label":{"en":["Dr. Jane Weida interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295058/transcript/85356/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Side 1\n\nDr. Young: This is side 1 of tape 1 of the oral history of Dr. Jane Weida, a member of the Board of Directors of Family Medicine for America’s Health. We are recording this on August 29th, 2018.\n\nI’m Dr. Herbert Young, a volunteer at the Center for the History of Family Medicine. \n\nDr. Weida, do we have your permission to record this interview?\n\nDr. Weida: Yes, you do. Thank you.\n\nDr. Young: Could you give us your full name?\n\nDr. Weida: Jane Ann Weida, MD.\n\nDr. Young: And your present title and positions?\n\nDr. Weida: I am Interim Chair for Family, Internal and Rural Medicine at the College of Community Health Sciences, University of Alabama. Also Director of Clinical Affairs, Associate Residency Director and Associate Professor. \n\nDr. Young: Could you talk a little bit about your professional background coming up to this point?\n\nDr. Weida: How far back do you want me to go? At least maybe college. I grew up in southern New Jersey, went to college in southeastern Pennsylvania, a small liberal arts college called Ursinus. I majored in biology. I originally was going to do medical school and decided I wanted to go to graduate school. So when I got my bachelors degree in biology I went to the University of Sciences, is what it’s now called, was called Philadelphia College of Pharmacy and Science at the time, and I got a masters degree in pharmaceutical chemistry. Then I worked at Merck Sharp and Dohme doing research labs for six years. After that I enrolled in medical school at Jefferson Medical College in Philadelphia. I finished there in 1986 and I did my residency in family medicine, it was called family practice then, at Chestnut Hill Hospital which is on the northwest corner (?) of Philadelphia. After that I joined a family physician about fifteen minutes from my home and fifteen minutes from the hospital in Bloomingdale, Pennsylvania which is a suburb of Philadelphia. I practiced there for thirteen years and decided to go into medical education, so I moved out to the Lancaster County area of Pennsylvania and started working at Penn State College of Medicine in Hershey. I worked in two different outpatient clinics there. Most of what I did was patient care but I also did some medical student training and had a couple of grants where I worked on innovations in educational strategy. From there I wanted to do residency education. But there was no family medicine residency at Penn State, so I moved to Reading Hospital which is a suburb of Philadelphia. It’s a large community hospital, and stayed there for six years. Then almost exactly three years ago I moved to Alabama to the University of Alabama College of Community Health Sciences which houses the third largest family medicine residency in the country at forty-eight residents per year – and that’s where I am now.      \n\nDr. Young: A very full background.\n\nDr. Weida: Thank you.\n\nDr. Young: So industry, practice, academics. And you’ve also had involvement with organized medicine.\n\nDr. Weida: Right. I started out on a small scale in the late 1990s. I started out on the board of the Penn State Academy of Family Physicians Foundation and worked my way up to the president of the foundation. Then we decided to merge the two, the foundation and the regular board, so I got on the Pennsylvania Academy Board and worked my way (?) there. Was president in 2007. And then after that I was able to do alternate delegate and delegate to AAFP Congress of Delegates. And that continued until we moved to Alabama in 2015. I also, in about 2005, started on the board of the AAFP Foundation. And after about four years I moved up to treasurer and then from vice-president to president. I was the president in 2014. One of my proudest accomplishments was I led the task force to develop signature (?) humanitarian programs both domestically and internationally. Domestically we support new clinics that serve the uninsured and under-insured by giving them grants to help them get started. Also, we give grants to existing clinics to help them purchase equipment they might need that helps Family Medicine Cares USA. The other program is called Family Medicine Cares International and that involves a yearly trip to Haiti where we do patient care and family medicine education as well as children and orphanage projects. We also do a faculty development for the faculty at the --, the family medicine residency in Haiti, and that’s several times a year. And we do a medical symposium for physicians in Haiti as well and we go on a yearly delegation trip in February every year.\n\nDr. Young: How did you get involved in Family Medicine for America’s Health?\n\nDr. Weida: Well, it so happened that at the time that the board was forming the first eight members of the board were people who were in leadership at the eight family medicine organizations. So I was the president at the time of the AAFP Foundation. I was actually kind of wondering what I was going to do next. After being the AAFP Foundation president I was looking for something else to keep me involved nationally and this came up and it was a perfect fit for me to move into. So that’s how I did that, I happened to be in the right place at the right time.\n\nDr. Young: As you think about it, what knowledge and skills do you feel you have particularly brought to the project?\n\nDr. Weida: I think that probably organizational skills. I think I get along well with people. I’ve been involved on a lot of boards and I think that helps me know how to interact with people on boards. I think those are the main things.\n\nDr. Young: And Family Medicine for America’s Health, as you mentioned earlier, is an activity that eight family medicine organizations all participate in. So this has put you in contact with segments of family medicine that you’re probably very familiar with. But are there any organizations that this was sort of a new experience?\n\nDr. Weida: Initially ACOFP, the American College of Osteopathic Family Physicians, was not a member of the working party, which is the leaders (?) get together twice a year. And that’s actually where Family Medicine for America’s Health hatched. But because we felt it was important to include the DO family physicians we started looking at them as well and so they were the eighth organization to join. So I didn’t have a lot of contact with them, so decided to also do the Interactive (?) Family.\n\nDr. Young: Thinking back to when you first started with Family Medicine for America’s Health, \n\nbut then also today now that the project has been active for these years, what in your view was the initial value and purpose for Family Medicine for America’s Health and has it changed at all?\n\nDr. Weida: I think our initial aims were to move family medicine forward to help family medicine help our patients, help family medicine and primary care help the patients. And primary care (Inaudible) the Quadruple Aim: Better care, better health, better -- health, better access and better doctor satisfaction. Of course that’s a pretty big pill to swallow but that was our initial aim, was to help move family medicine forward to achieve its Quadruple Aim.      \n\nDr. Young: And in fact, as you said, I think it went from a triple aim to a quadruple aim. Right. So that was at least one way that things evolved over the course of the project to this point. Any other aspects that come to mind particularly?\n\nDr. Weida: One thing that we thought we were going to include at the beginning that we didn’t was the emphasis on improving health equity, so we added that as a seventh team. We had six tactic teams that reported to the board and we thought those six tactic teams could move health equity into their projects, but in fact they were so busy and had so many projects to do that that was not going to happen unless we formed a different tactic team – and we did do that a couple of years ago. \n\nDr. Young: Any particular reason why that occurred at this point in the history of family medicine and of healthcare in the United States?\n\nDr. Weida: There are several aspects of improving health equity that we just haven’t focused on enough. We have seen in the newspapers and on the internet just the past couple of weeks, the importance of including social determinants of health in our healthcare because that is probably at least as important, if not more important, than the medical system itself. And that’s something that we need to be willing to meet our patients where they are and figure out how we can help them in their situations. If we try to give somebody a pill for hypertension in the homeless, it’s not going to help them a lot. So that’s a really important thing. We also need to insure that patients are covered and that they have a family physician. That’s the second best thing we can do for them besides making sure that we check their social determinants just to make sure that they have access to affordable quality healthcare, a family physician or their primary care provider. And that’s so vital and important to the nation’s health. \n\nDr. Young: Let me ask it this way: What, in your opinion, is the state of healthcare in America as the project started? And then what has Family Medicine for America’s Health done that addresses those needs?    \n\nDr. Weida: The state of healthcare in America is obviously far from where we would like to see it. It’s not ideal at all. We spend twice as much as any other developed country and our outcomes are dismal. So we certainly need to improve that. We need to lower the costs but we also need to improve the outcomes. In order for us to do that we need to look no further than to what Starfield data shows, that if you have more family physicians in the area the quality goes up and the cost goes down. And as much as need our specialty colleagues, if you have more of them in an area the quality goes down and the cost goes up. So as much as we need our specialty colleagues, we need many, many more family physicians to take care of the patients so that they have continuity of care, that they see the same provider or the same team of providers so that they get better healthcare. And we also need to absolutely insure that everyone in this country has health insurance. I feel very strongly that that’s a right and not a privilege. And the Affordable Care Act has helped. We’ve gotten a lot of uninsured. But compared to 2010, when it first started, we have a lot fewer uninsureds --.\n\nDr. Young: And is it strictly that we need more family physicians or does the specialty have to change in any way in order to meet these needs?\n\nDr. Weida: Well, we do need more family physicians. We also need support for families. And I’m not sure how this would occur, but we need support to encourage family physicians to go into areas where they wouldn’t normally go, like very rural areas that target support of family physicians. Or we can also use innovation to provide telemedicine, that sort of thing, where you might not have to have a family physician in an area, but if you had a family physician who could provide telemedicine care to a very rural area, that’s something we need to beef up. And it’s not going to happen all that much unless it’s paid for. So we need to make sure that we can get paid for giving care remotely as well as physically. \n\nDr. Young: So part of it, I think you’re saying, is that the payment system as previously structured just wasn’t supportive of the things that need to be accomplished. And was that, in fact, I think part of what Family Medicine for America’s Health looked at? \n\nDr. Weida: That is absolutely right. The payment core tactic team has been diligently working on that. And while we don’t have any notion that we’re going to totally change the payment system, we are very much pushing for value-based comprehensive payment for our physicians so that we can get paid to keep our patients healthy and do the innovative ways of taking care of our patients that we need to do that right we can’t get paid for. We need to pay our family physicians in ways that enable them to pay the extremely high debt that many medical students incur when they finish medical school. And sometimes they simply can’t choose family medicine because they can’t afford those hundreds of thousands of dollars, a milieu worth of debt that they come out. We need to find ways where that helps repay that and make the salaries more competitive with\n\nother specialties. \n\nDr. Young: So I’m hearing technology plays a role in improving how family medicine goes about providing care, payment changes, some of which I guess were already occurring one way or another from the government or from insurance companies. And then how one practices, has that also been an area of interest for the project?\n\nDr. Weida: Yes. One of the things we would very much like to see and is not exactly something we can fix is the electronic health record. We need something that works for us, not a --. And we have not been able to make very much of an inroad in that. I think of the ERHs are improving. They are way better than they were ten years ago. But it’s a frustration to every doctor in American, I think, the slowness and how ineffective many of the EHRs are. And then error operability. It’s really, really expensive to change from one to another. And it affects productivity. There are just so, so many things that while EHRs are actually essential in order to keep up with everything you need to keep up with, they also provide a real roadblock in terms of time. And a lot of family physicians are spending two and three hours a night doing their charting. The ones who are in full time practice are just spending way too much time outside of the office doing their chartings and this is not good for their well-being – and they should be able to get their work done.          \n\nDr. Young: In terms of practice, was there, I believe, some outreach to the rest of primary care? And I’m thinking both within the physician community but also within nursing or physician assistants?\n\nDr. Weida: We did not reach out to them per se. We reached out a little bit to internal medicine and pediatrics and there wasn’t as much interest as we thought there was going to be. So we haven’t excluded them but they haven’t really been included that much with all of these plans. Because they are also very important in an Alzheimer care structure.   \n\nDr. Young: As physician specialties do you think that there is a significant difference between what draws medical students to family medicine as opposed to pediatrics or general internal medicine? I’m sorry, can you repeat that? Within primary care do you think that there’s something distinctly different that draws medical students to family medicine as opposed to just pediatrics or just internal medicine? And if so, how does that relate to the solutions and approaches that Family Medicine for America’s Health may have undertaken?\n\nDr. Weida: I think that probably all of our primary care colleagues are pretty idealistic and want to help the world, change the world. So I don’t think there’s a huge difference. But certainly I hear a lot from medical students who absolutely know they want to go into pediatrics or absolutely know they want to go into the trauma centers. And the ones who tend to go into family medicine are the ones who say, wow, I just loved everything. I loved all my rotations. I want to do full spectrum care. And I think that’s the difference in that they do want to see everybody. They do want to maybe provide baby care or maybe just prenatal care. They want to do everything. They want to be the family doctor who sits on the school board, that sort of thing. And that’s what I see family doctors as being a little different from our other primary care colleagues – but not hugely different. \n\nDr. Young: And in terms of working with other providers beyond physicians, any thoughts there?\n\nIn terms of working with mid-level providers, something like that? Yeah, within the structure of how practices are operating now or maybe in the future.\n\nDr. Weida: I wish that our mid-levels and our physicians were able to have a little less territoriality (I know that’s not a word), what would be a little territorial. And I think we could provide much broader care if we could work together a little bit more because, yes, the nurse practitioner or a PA does not have the same training, the same clinical skills that we have but they provide -- of care in certain instances and I think we need to work with them more. And I was thinking primarily within practices as opposed to freestanding. We do not have too many mid-levels in our residency clinic but we do have one PA who sees patients and we have a faculty staff clinic here that is staffed by nurse practitioners who see patients who are employees of the University of Alabama. So we do work very closely with them. We’re happy to have them to take care of all those patients. And if the patient has a chronic condition that they feel they need to see a physician, they will send them over to the faculty or to the residents. So there’s a really nice working relationship that we have here. But it’s different from a private practice because it employs our nurse practitioners to see some of their patients.\n\n\nDr. Young: You have a physician that has to pay attention to rural medicine. Anything that you would like to share in terms of what are the challenges of rural practice and has there been anything that Family Medicine for America’s Health has particularly done that would relate to rural practice?\n\nDr. Weida: Rural practice, as you know, is quite a challenge because a lot of people don’t want to live in those areas, for one thing. A lot of physicians don’t want to live in those areas. If you try to go to a town that has 500 people, you can’t support yourself. You can support yourself in a town of 2500 or so, but the challenges include getting time off because you can’t be there 100% of the time. So you need to set up networks where you can work with other physicians. But sometimes if it’s very rural, you don’t even have that opportunity. If the town is very small, you might want to have your family there because maybe the schools aren’t as good. There might be a little hospital that might have been there for 100 years and is closing because it can’t keep its doors open. And then your patient task is to go an hour and a half to a big hospital. So that is a big problem, those tiny community hospitals that are closing and therefore the family doctors can’t take care of their patients in hospitals. So there are a lot of challenges. A lot of people really do like rural practice, but most people would prefer a suburban or a city practice where there are amenities for their children and for themselves. It’s a lot harder to support a family and somebody who wants to do full spectrum medicine way, way out in a tiny community, but we need those doctors to do that.\n\nDr. Young: Do you think that the students who are drawn to medicine, family medicine in particular, have different expectations of how they would live their life compared to perhaps physicians of fifty years ago?\n\nDr. Weida: I think some of the older doctors think that the younger doctors don’t want to work as hard. I don’t necessarily agree with that. I think that their expectations are, however, that they don’t want to be overworked – and that’s okay too. They want to have time to get home to their friends and their families and that’s perfectly appropriate. But they also want to provide excellent care to their patients. So I don’t think they’re lazy. I think they are absolutely committed to family medicine but they want to do it differently than we did it fifty years ago so that they don’t burn out.\n\nDr. Young: A bit ironic that family medicine would draw people who (and I’m saying this a bit in gist) are interested in family, including their own. \n\nDr. Weida: Well, they do want to be there for their family and for their friends and to have time to enjoy life and not to just always be on call and not to just always be working because that’s not good for anyone.\n\nDr. Young: Do you think there’s a solution to that challenge? And I’m looking at it broadly – obviously keeping small hospitals open as part of it and living in an area that doesn’t have quite the same offerings that a larger community might, but do you think we’ll solve the issue of how to provide good care in rural America?\n\nDr. Weida: Well, I think there are ways that it could be done if the payment system were different. If you had several doctors that could share a care coordinator or a social worker and you could actually get them paid for what they do. Right now in private practice they often don’t get paid and the doctor has to absorb the money to pay these people. They should be able to bill for their services. And that’s one of the major things that we need to do, to pay the people that provide ancillary services to our patients. We also could look at payment reform in terms of having mid-levels to advise and nursing as well to provide care to the patient over the phone and do some small things so that frees the doctor up to spend more time with the patients so that they can deliver better care. But if you spend a lot of time with your patients right now, it’s hard to get reimbursed properly. So if we had comprehensive -- the payment, then you could parse out some of the smaller stuff to nursing and mid-level people and spend more time with your patients yourself. That would be something that could be really, really helpful.  \n\nDr. Young: We’ll pause at this moment so that the tape can be turned over.\n\n\nSide 2\n\nDr. Young: This is side 2 of tape 1 of the August 29th, 2018 interview with Dr. Jane Weida, a member of the Board of Directors of Family Medicine for America’s Health.\n\nWould you comment a bit on how you think the work of Family Medicine for America’s Health will be carried on as the tactic or core teams are signing off? And if you were familiar with the Future of Family Medicine project, how this might differ? \n\nDr. Weida: I’ll do the first part of the question first. At our last working party meeting, which was just a couple of weeks ago, we talked at some length with people who were there from the national family medicine organizations. Some of the projects have already been handed off to various organizations and eventually they will all be handed off to organizations like the AAFP, ABFM, that sort of thing. So the organizations themselves have stepped up quite a bit to absorb these tactic teams, what has come out of the tactic teams. So they will be carried on and I’m very grateful that they’re not going to, five years of the tactic team and their projects are not going to just sit there. We need to keep going with them.\n\nDr. Young: At least my experience when I worked for the Academy with the Future of Family Medicine was that some things were handed off and worked well but there wasn’t really any follow-up, it seemed, across the organizations. And I know of at least one case of one of the objectives of the ten that took a little while to find a home - but did ultimately. But this seems to have been structured a little differently.\n\nDr. Weida: Yes. I was only just getting involved nationally when the first Future of Family Medicine project came out. And I read the publication about it but it didn’t really follow up on where the projects went. And I’m not sure that it was really well-publicized about where they went, although it might have been and I just didn’t see it. But this time I think the hand-offs are really going well and I have real reason to believe that the national organizations will continue to work on this project. And AAFP has really stepped up. Particularly AAFP has -- to health equity, that is taking on many of the projects of the health equity team. And STFM is really stepping up to place with improving student interest in family medicine. One of the goals that the workforce team came out with was the so-called 25 By 30 where 25% of medical students will go into family medicine by the year 2030. And so STFM is really stepping up to the plate to do that. And they are also interested in health equity as well and they are working with the team as well. So a lot of interest among the teams.\n\nDr. Young: Thinking about your own state, is that percentage by that date likely?\n\nDr. Weida: Probably not. We don’t have a lot of medical schools and the one that is an hour away, University of Alabama at Birmingham, is not all that family medicine-friendly. It has a tiny family medicine department. But I believe that if we can give students some amazing experience here in our building and show them how diverse you can be as a family doctor and show them how many scholarships they can do and that sort of thing, I think we can definitely speak to a number of students that way.\n\nDr. Young: And you had mentioned the cost of medical school and the debt then that medical students are facing. What’s the solution there?\n\nDr. Weida: I think you have to be creative when you do this. I know that Penn State College of Medicine has instituted the program where the fourth year of medical school is actually the first year of residency as long as the person agrees to family medicine. And so they’re cutting off a year of medical school debt and not affecting their education because most of fourth year is spent doing electives and flying around the country looking at residencies. So that could be one innovative way to cut back on the amount of debt. You have 25% less debt when you enter residency because you didn’t have a fourth year of medical school. So that’s one way. Another way is to ask communities to step up and support family physicians. Anyone coming to a small community, how can they help the family physician get started. The states should, I think, very much support family physicians who want to go into particularly under-served areas. Some states do this but I’m not sure they do it enough. Support family physicians who want to go into under-served areas and give them a break on their med school debt. So there are lots of ways to do it but we have to be creative and there have to be a lot more opportunities than there are right now. \n\nDr. Young: So that local community support is sort of a variation on the National Health Service Corp?\n\nDr. Weida: Pretty much, yeah. But there is a community about an hour and a half from here that has a tiny hospital. And I was talking to an RN who works there, who is from there, and she said that they are determined not to have that hospital close and the community rallies around the hospital and has fundraisers and all that sort of thing to make sure that their little hospital stays open.\n\nDr. Young: Some parts of rural America have very large agricultural companies involved and others I assume are smaller community, not dominated by a single industry or interest. What do you see in your state?\n\nDr. Weida: Well, I’ve only been here three years and most of Alabama is extremely rural and very poor and the tiny towns tend to have a pizzeria and a Mom \u0026 Pop grocery store and not a whole lot else. There is some industry. There is logging --. There is a big Mercedes plant about fifteen  miles from the university. There are a number of universities that support people. The University of Alabama has 37,000 students and that’s the biggest employer in Tuscaloosa and probably one of the biggest in the state. So there is some big industry but not as in other places. But, of course, Alabama is very rural.\n\nDr. Young: So probably the solution is really not “the” solution, it’s solutions that will be reflective of the community resources commitment and so forth. But all impacted by how the healthcare system is going to pay family physicians and others in primary care to do what needs to be done.\n\n\nDr. Weida: Well, we need to make the business case for primary care. People don’t understand what a family physician is. “Oh, you’re a GP,” (I get that all the time). We need to help them understand just what family physicians do to help a community and help its people and we need to be bearing that flag of how important family medicine is and how much we can bring to a community to help them. And I don’t think we quite give ourselves enough credit and we don’t let everyone else know how important family physicians are.\n\nDr. Young: Do you know if Family Medicine for America’s Health had activities in that regard?\n\nDr. Weida: Absolutely. More than half of our funding went to our communications campaign which is still going on. And we’ve had key communication experts that have been so committed to our campaign, it’s called Health Is Primary, that they actually quit their full time jobs at the place where they were working, a communications firm where they were working, and have been working for us for the past two (?) years. And initially they were going all over the country. Now they have concentrated a lot of their work in Washington, DC and the -- working party had a board meeting and presented how much the recognition of how good primary and family medicine has gone up. People remember it. I can’t tell you how many billions of it they have tracked in terms of people learning about what family medicine is. You know, interestingly, about a year and a half ago the eight family medicine organizations wanted us to do a -- and put more money into the communications arm. And that was a good thing because they wanted us to concentrate in DC. And we didn’t know it at the time but with the change in government we needed to be there. And so they’ve made great inroads, made a lot of friends in DC to teach them about how important family medicine is.      \n\nDr. Young: And it sounds like a challenge because the patient obviously is an important person to understand what family medicine offers but the decision-makers in government and industry, purchasers, et cetera – we’re a big nation.\n\nDr. Weida: Absolutely. We’re trying to -- in here. Indeed.\n\nDr. Young: What else would you like to share in terms of insights that you might have as a result of being in Family Medicine for America’s Health or things that now, as you look into your own professional life, resonate particularly well, et cetera? \n\nDr. Weida: I think that having the opportunity to work with leaders of all of these family medicine organizations has been invaluable to me. Being on the Foundation board, it’s on the small side in terms of its impact nationally in terms of getting to know other people and that sort of thing. This has enabled me to look at all of the organizations to find out how they fit and what makes them tick and how we can work together. I think that having Family Medicine for America’s Health -- and all of the working party meetings have also helped the organizations themselves to come together and work together. Because it’s easy for them to go back and be silent but I can see a real inter-organizational commitment to work on a lot of these projects and that makes me feel very good. Am I answering your question? Indeed. \n\nDr. Young: You might take a moment though to share a little bit about what is the working party.\n\nDr. Weida: The working party is not at all a party but it is work. Twice a year the leaders of the eight family medicine organizations get together for two days and work with each other. So the organizations are the American Academy of Family Physicians, AAFP, the AAFP Foundation which is the philanthropic arm of the Academy, STFM, the Society of Teachers in Family Medicine, NAPCRG, the North American Primary Care Research Group, ABFM, the Board of Family Medicine that makes sure you’re board certified, AFMRD, the Association of Family Medicine Residency Directors (and there are 400-and-some family medicine residencies in the country), the ADFM which is the Association of Departments of Family Medicine. And finally the ACOFP, the Osteopathic Family Physicians. So the current leaders of all of these organizations, whether it be the president-elect, president, board chair or however it is, the current leaders come together twice a year and work for a day and a half or two days, depending on which organization it is, and then work together to share what each of them is doing and also to interconnect and get to know one another. When I went to working party before Family Medicine for America’s Health started we didn’t have as much continuity between meetings. And now Family Medicine for America’s Health has provided the common thread and we talk about it at every meeting, we spend quite a bit of time on it at every meeting. And that has, I think, really helped everybody work together and form a community. I’m hoping that we are able to continue this. \n\nDr. Young: And when you say it was lacking continuity previously, meaning in the content or the people attending or both?\n\nDr. Weida: Unfortunately we can’t do a lot about the continuity because the leadership of the organizations is going to change. The staff is going to be constant, the ADPs (?) and other people that come. But when I’m talking about continuity-wise was we would come together, have some really good ideas and some really thought-provoking discussions. But then unfortunately as things happen, you often go back to your regular job and you don’t work on those things you talked about at the meetings. But that’s not the case now because the common thread is Family Medicine for America’s Health and the representatives of all eight of these organizations continue to give feedback to the eight organizations and keep them up-to-date of what’s going on. And so I believe it is different.\n\nDr. Young: Any other thoughts that you would like to share?\n\nDr. Weida: It’s been a real privilege for me to work on this because I’ve worked with some amazing, amazing leaders in family medicine that I would never have gotten a chance to do, I think, otherwise and it’s been a real honor. So I thank them.\n\nDr. Young: So it would be nice to figure out how to keep relationships going and developing beyond the working party? Right. So I believe some of the tactic teams or core teams, I’ve heard them referred to with at least two different names, maybe three. Yes, tactic teams or core teams, core tactic teams. That relationships have developed there that sound like they’re going to carry on as well.\n\n\nDr. Weida: NAPCRG, the research tactic team has kind of morphed into NAPCRG and they’re continuing to do their work. And I think the -- team, at least the leaders, have been involved with AAFP. So I think a lot of this, there have been some really strong bonds formed. And it’s been a lot of work for both the tactic teams and the board and I think a lot of us will continue to keep in touch as we work to further the -- of family medicine for our patients.\n\nDr. Young: And one other way that there might be some continuity is in approximately five to seven years the plan is for the Center to come back to those who have been interviewed before and ask a few follow-up questions. Is there a question or questions that you think would be particularly valuable to ask in five to seven years?\n\nDr. Weida: Well, there are questions on the questionnaire to be asked of those participants in five to seven years. Feel free to look over that list and then share with us beyond this one chance of recording if there are any that you think would be particularly good. I’ll think about that because I’ll be very interested in five to seven years how much of this is still going. I would love for us to look at the Future of Family Medicine not as a point in time every ten years but I would like us to continue to look continuously at the Future of Family Medicine and what can we do to improve family medicine, to improve the care we give our patients, to improve the healthcare of all of our citizens, not just the point in time of every ten years. I’d love for there to be a center for the Future of Family Medicine. What an interesting idea.\n\nDr. Young: Thank you so much for taking the time to do this. It was my pleasure. And we’ll be sending you a transcript for review.\n\n(End)","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295058#t=0.0,1771.8768"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295057","type":"Canvas","label":{"en":["Media File 2 of 2 - WeidaJane_02_Access.mp3"]},"duration":1190.7603,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295057/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295057/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/295/057/original/WeidaJane_02_Access.mp3?1760553895","type":"Audio","format":"audio/mpeg","duration":1190.7603,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3491/collection_resources/162272/file/295057","metadata":[]}]}],"annotations":[]}]}