NC Family Physician - Summer 2024

Volume 20 Issue 3 • Summer 2024

The North Carolina

Family Physician Quarterly News in North Carolina Family Medicine

Navigating the Ethical and Responsible Integration of AI in Clinical Practice PG. 26

Inside Summer 2024

Optimism for the Future of Family Medicine PG. 4

PRESIDENT'S MESSAGE

MEMBERSHIP SERVICES

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20 Member Spotlight: Stacey Blyth, MD

Optimism for the Future of Family Medicine

ADVOCACY

RESIDENTS & NEW PHYSICIANS

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24 What’s Next for Graduating NC Family

On The Road Advocating for You and Your Patients

PROFESSIONAL DEVELOPMENT

10 The 2024 Winter Family Physicians Weekend is

HYBRID — Making It a “Must-Do” CME Opportunity for Everyone!

Medicine Residents

PRACTICE MANAGEMENT

26 Navigating the Ethical and Responsible Integration of AI in Clinical Practice

PUBLISHED BY

DEPARTMENTS

t 919.833.2110 • fax 919.833.1801 • ncafp.com

President's Message 4 Advocacy 6 Professional Development 10 Membership Services 20

Editor Kevin LaTorre, NCAFP Communications Managing Editor, Design & Production Peter T. Graber, NCAFP Communications

Residents & New Physicians 24 Student Interest & Initiatives 25 Practice Management 26

Have a news item we missed? NCAFP members may send news items to the NCAFP Communications Department for publishing consideration. Please email items to kevin@ncafp.com.

Material in articles and advertisements does not necessarily express the opinion of the NCAFP. Official policy is formulated by the NCAFP Board of Directors.

PRESIDENT'S MESSAGE

By Garett Franklin, MD, FAAFP NCAFP 2023-2024 President

Optimism for the Future of Family Medicine I recently had an encounter with a colleague who I have revered as a mentor since my days before medical school.

He is a practicing community physician in a specialty outside of Family Medicine. He revealed his concerns for our profession and seemed pessimistic about the future. I

was quick to retort with a completely different outlook.

I shared how I am optimistic about the future of Family Medicine, even if the wheels of change seem to be slow to move. Furthermore, I am confident in the forces that are moving Family Medicine forward in our state and nation.

I hope this article will satisfy his concerns and other physicians that might have doubts.

The greatest source of my enthusiasm is the increasing at-

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tention to investment in our primary care system. Compared to other countries, the United States currently under invests in primary care. About 5% of total medical spending is attributed to primary care. However, in other nations, that number tends to be closer to 10-12%.

But through the advocacy work of NCAFP and many other organizations, leaders at the federal and state levels are starting to take notice. They are realizing that increasing payment to family doctors keeps them seeing patients.

There is an equally pressing need for greater investment in resources for nursing, staffing, practice management, technology, and many other areas to keep physicians delivering high quality patient care. The most tangible evidence of this investment is the development of the North Carolina Primary Care Payment Reform Task Force. This task force was legislated in 2023 and convened earlier this year.

The Task Force has already submitted some preliminary

recommendations to our state legislature about ways to better invest in primary care. You will be happy to know that Family Medicine was well represented on this panel by some of your NCAFP leaders. This is just one example, and I am optimistic there will be more good news as the months progress.

I am also encouraged by growing scrutiny of the administrative burden that we all feel daily. We are all concerned

The North Carolina Family Physician

2023-2024

about spending too much time on computers and not enough face-to-face time with patients. Many projects targeting solutions, ranging from scribes to AI, are currently being explored by our members. Moreover, prior authorizations are commonly cited as a pain point for many of our members. Your NCAFP leaders have been actively engaging payors regarding this topic on a regular basis. Legislation at the federal and state levels regarding prior authorizations is starting to gain traction. We are also engaging our friends in sister organizations like the NC Medical Society and the NC Pediatric Society to help gain leverage.

NCAFP Board of Directors Executive Officers President

Garett R. Franklin, MD, FAAFP

President-Elect

S. Mark McNeill, MD, FAAFP

Secretary/Treasurer

Benjamin F. Simmons, MD, FAAFP

Immediate Past President Shauna Guthrie, MD, MPH, FAAFP Executive Vice President

Gregory K. Griggs, MPA, CAE

At-Large Directors Josh T. Carpenter, MD

Bolstering our Family Medicine workforce is another area that's currently showing dividends. We love our medical students and residents and obviously want them in our profession and ultimately practicing in our state.

Supporting our students through loan repayments and grants was an enormous victory in the 2023 legislative cycle. The NCAFP fought very hard to create and implement these new programs for medical students. As you may remember, the Academy also kicked off a three-year campaign with the NCAFP Foundation to raise $6 million to fund our student programs, keeping them viable for the future. I am pleased to report that we are currently well on track to meet this goal. The NCAFP is also creating new programs to educate students about career paths and the diversity of practice styles available in Family Medicine. Supporting areas of high physician need is also a huge goal. The NCAFP was instrumental in securing funding for rural teaching centers in the last budget cycle to help foster student experiences in these critical areas.

In the future, I also envision additional support for our current Family Medicine workforce. We understand the desire for career flexibility, whether it looks like treating a different population of patients, teaching students, conducting research, or expanding into the administrative side of medicine.

The NCAFP is exploring ways to support our members in all career pursuits while maintaining patient care.

The future of Family Medicine is bright because you belong to an amazing organization. The NCAFP has always been at the heart and soul of our specialty, in my experience. Its staff and leaders are great at providing CME and reporting, but they are so much more. The NCAFP has always been a trusted source of news, information, and communication, with the COVID-19 pandemic serving as a prime example. Meetings and events promote comaraderie, physician well-being, and times of refreshment. The Academy is a place where future leaders are cultivated to lead. However, the NCAFP’s passion for Family Medicine, patients, and members physicians truly sets it apart. The future of Family Medicine is bright when organizations like NCAFP exist to support physicians.

Lastly, I am optimistic about the future of Family Medicine because of the hardworking and dedicated family physicians who provide an unparalleled, sacrificial service to our family, friends, and neighbors across our state. I am always humbled to hear of the amazing things NCAFP members are doing even amid challenges. I can only imagine how much better the future will be with more investment to help you perform at your peak. I can’t wait to see it!

Lisa A. Cassidy-Vu, MD, FAAFP Deanna M. Didiano, DO Nichole L. Johnson, MD, MPH, FAAFP Kelley V. Lawrence, MD, IBCLC, FABM, FAAFP Amanda R. Steventon, MD, FAAFP Patrick S. Williams, MD Courtland D. Winborne, MD Academic Position R. Aaron Lambert, MD, FAAFP Resident Director Morgan Parker, DO Resident Director-Elect Stephanie P. Wilcher, MD, MPH Student Director S. Evan Morgan Student Director-Elect Nicholas Wells

AAFP Delegates & Alternates AAFP Delegate

Richard W. Lord, Jr., MD, MA, FAAFP

AAFP Delegate

Robert L. Rich, Jr., MD, FAAFP

AAFP Alternate

Tamieka Howell, MD, FAAFP

AAFP Alternate

Thomas R. White, MD, FAAFP

NCAFP Committee Chairs Workforce Pipeline Chair

Jay Patel, MD, MPH

Advocacy Committee Chair

Deanna M. Didiano, DO

Member Satisfaction Nichole Johnson, MD, MPH, FAAFP and Practice Environment Committee Chair Academic Departments Chair

Margaret Helton, MD, FAAFP

NCAFP Foundation President

Maureen Murphy, MD

2501 Blue Ridge Road, Suite 120, Raleigh, North Carolina 27607

Summer 2024

www.ncafp.com

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ADVOCACY

By Gregory K. Griggs, MPA, CAE NCAFP Executive Vice President & CEO

On the Road Advocating for You and Your Patients Occasionally, I try to look back and see the types of meetings and events that NCAFP leaders and staff attend to represent you, our members. This year, it seems like the meetings and general travel to advocate for Family Medicine in our state have been more extensive than ever. So, I took a moment to reflect on our global NCAFP calendar to describe where we have been representing you. This description is only a sample of what we have been doing on your behalf in the past six months.

LEGISLATIVE AND PAYER ADVOCACY Not surprisingly, advocacy with legislators and payers has been at the top of our agenda. As an example, NCAFP President-Elect Dr. Mark McNeill represented our members in a series of five meetings of a legislative-directed group, the Primary Care Payment Reform Task Force. The goal of the Task Force is to increase investment in primary care. While the initial work of the Task Force is done, it is only the first step of an ongoing effort to show the value of primary care. As I write this article, we are preparing for a group of NCAFP leaders to meet with the NC Association of Health Plans about how to implement some of the recommendations of this Task Force, including voluntarily measuring and reporting the percentage of the health care dollar that insurers currently allocate to primary care, and ultimately how to increase that percentage. Your NCAFP has also made a major investment in advertising the importance of Family Medicine and primary care through a series of radio ads on 80 stations across the state, social mirroring, and a new website: www.primarycarenc.org.

Beyond this advocacy, we have had an extensive and continuous presence in the General Assembly this year. In early May, our White Coat Wednesday brought over 40 family

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physicians, Family Medicine residents, and medical students to the General Assembly. The next week, we had another 15 or so residents visit the General Assembly from both the East Carolina University Rural Track and the University of North Carolina Family Medicine residencies. And your staff, leaders, and government affairs consultants are constantly meeting with our elected officials. Beyond the work on primary care investment, we have focused on reducing administrative burden through legislation that would reform the prior authorization process in North Carolina, as well as directly advocating with insurance companies to ask them to reduce the number of procedures and referrals which require prior authorization from family physicians.

Along the way, we attended a number of fundraisers for legislative candidates, represented Family Medicine at an event for physicians and PAs running for the General Assembly in November (there are a total of five candidates from the House of Medicine this year), and multiple legislative receptions, including one hosted by the Association Executives of North Carolina and another by the NC Medical Society.

The bottom line? We are in front of your elected officials on a weekly if not daily basis.

Finally, we regularly meet with insurance payers in North Carolina, either on a set schedule or an ad hoc basis. As Aetna begins administration of the State Employees Health Plan at the beginning of next year, we have stepped up efforts to meet with their leaders. Dr. Jessica Triche began service on the Blue Cross and Blue Shield of NC Physician Advisory Group (PAG), taking over for Dr. Alisa Nance, who finished her term representing NCAFP on that PAG. In turn, Dr. Triche has completed her service on the NC Medicaid PAG, and Dr. Ying Vang from Newton Family Physicians is replacing her as our representative there. In addition, I personally represent you on the Duke-Margolis Institute for Health Policy’s Executive Roundtable that includes health plan presidents, health system executives, policy leaders, and other members who come together quarterly to discuss how to transform health care in North Carolina. The consensus of the group places primary care at the center of that transformation.

PRACTICE VISITS Current NCAFP President Dr. Garett Franklin has made getting back out to visit member practices one of his priorities for 2024. We had one day of local practice visits in late February and plan to visit some practices in the western Piedmont and foothills later this year.

The North Carolina Family Physician

First, in February, Dr. Franklin and members of the NCAFP staff visited three Wake County practices to better understand their needs. We had great discussions with about 15 member physicians, particularly focusing on the current workforce needs of primary care practices, whether it’s the clinical workforce or the front office staff. Also in February, NCAFP staff visited three practices who participated in a grant we received from UnitedHealthcare. Hodges Family Practice (Asheboro), Clinton Medical Clinic (Sampson County), and MedNorth FQHC (Wilmington) all received funding to hire additional medical assistants/scribes to improve access to both in-person and telehealth visits by improving administrative workflow.

These practice visits were also very helpful to understand the day-to-day issues impacting frontline Family Medicine practices.

FAMPAC

Empowering Family Medicine

RESIDENCY AND MEDICAL SCHOOL VISITS We have also been concentrating on the Family Medicine workforce of tomorrow by visiting more residencies than we have in recent years and by restoring our outreach to medical schools to our pre-pandemic levels. We have been especially excited about a number of didactic presentations we deliver to our resident members, covering everything from practice models to employment contracts to Medical Board regulation to Advocacy 101. In recent months, representatives of the NCAFP have visited Family Medicine residencies in Boone, Chapel Hill, Charlotte, Concord, Durham, Fayetteville, Greensboro, Lillington, Wilmington, and other cities. Our Senior Vice President and General Counsel Shawn Parker, JD, MPA, has also been working with numerous residents on the intricacies of their employment contracts.

HONORING THOSE IN LEADERSHIP ROLES AND THOSE SEEKING SUCH ROLES In March, I attended the national meeting

continues on next page

Summer 2024

JOIN THE FIGHT FOR FAMILY MEDICINE See 'Governor's Institute' on back cover Continues on next page

Participating is easy --

• Get to know your elected officials and become their trusted healthcare advisor.

• Contribute so we can support candidates that support Family Medicine.

• Participate in NCAFP’s ongoing advocacy events and efforts.

To learn more about FAMPAC and donate, visit www.ncafp.com/fampac

continues on Back Cover

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of the American College of Osteopathic Family Physicians (ACOFP). Our own Dr. Brian Kessler, Dean of the Campbell University of School of Osteopathic Medicine, became ACOFP President during that meeting. It was great to interact with so many of our osteopathic colleagues from around the country, and I also met with many medical students, residents, and physicians from North Carolina.

I witnessed innovative CME and great policy discussions at the ACOFP House of Delegates, and of course, I got to see Dr. Kessler installed.

Turning our attention to the American Academy of Family Physicians (AAFP), North Carolina has two candidates for AAFP board positions this year. Dr. Karen Smith, after serving on the AAFP Board for the past three years, is running for AAFP President-Elect. And Dr. Shannon Dowler is now running for a three-year term on the AAFP Board.

In April, our own Shawn Parker was elected as Treasurer of the Federation of State Medical Boards (FSMB). We also continue to attend numerous annual events that develop our future leaders, including AAFP’s Annual Chapter Leadership Forum and National Conference of Constituency Leaders, the AAFP National Conference for Students and Residents, and the Southeast Family Medicine Forum.

OTHER REPRESENTATION I also wanted to give you just a taste of the other meetings where NCAFP physician leaders or staff represent you.

Here is a sampling of the committees where we serve or the places where we have shown up to advocate for family physicians this year: • AAFP Family Medicine Advocacy Summit in Washington, DC • Aledade North Carolina Policy Committee Meeting • Collaborative Care Capacity Building Grants Advisory Committee • Community Care Physicians Network Annual Conference • Early Childhood Oral Health Collaborative • NC Center on the Workforce for Health • ECU Brody School of Medicine Dept. of Family Medicine All Faculty Meeting • Federation of State Medical Boards Annual Meeting • Medicaid Advanced Medical Home Technical Advisory Group • Medicaid Expansion Implementation Partners Meeting • NC Advisory Committee on Cancer Coordination and Control

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• NC Alliance for Health Professions Diversity • NC Clinician and Physician Retention and Well-Being Consortium • NC Immunization Coalition • NC Medical Society Advocacy Summit • NC Primary Care Payment Reform Task Force • NC Rural Health Alliance • Rural Primary Care Teaching Hub and Preceptor Task Forces • State Health Improvement Plan – Primary Care Clinicians Work Group • UNC-Asheville Health Policy Initiative for Western North Carolina • UNC Department of Family Medicine Huntley Lecture • And many more!

In closing, I also wanted to mention that NCAFP President Dr. Garett Franklin and I recently had the opportunity to talk about the challenges and opportunities of Family Medicine with a columnist at the Triangle Business Journal (a weekly publication focused on the business community in the Raleigh-Durham area). Dr. Franklin emphasized how the state and payers could use key policy levers to improve the primary care work environment and ultimately increase the number of medical students entering Family Medicine. We discussed the need for greater investment in primary care, the need to reduce administrative burdens in practice, and efforts of the NCAFP Foundation to provide early and frequent experiences in Family Medicine to medical students throughout the state, as well as our desire to increase our Medical Student Endowment. The article appeared on June 21.

Finally, your staff and leadership have been analyzing the results of our most recent Member Needs Assessment, which is conducted every three to four years. Nearly 20% of our Active members and close to 15% of our resident members completed the extensive survey. Your leadership is now reviewing that data and other information to update to the NCAFP Strategic Plan. Look for more information on any changes to our Strategic Plan in the fall edition of The North Carolina Family Physician.

The North Carolina Family Physician

PROFESSIONAL DEVELOPMENT

By Kathryn Atkinson, CMP NCAFP Director of CME & Events

The 2024 Winter Family Physicians Weekend is HYBRID — Making It a “Must-Do” CME Opportunity for Everyone!

The 2024 Winter Family Physicians Weekend, dedicated to advancing clinical knowledge, fostering camaraderie, and celebrating the vital work of family physicians, promises once again to be your favorite CME opportunity of the year! This year, we’ve introduced a hybrid format, offering you the convenience of attending all the terrific and timely mainstage lectures, whether in-person or virtually. Mark your calendars now for Thursday, Dec. 5 – Sunday, Dec. 8, 2024, and begin making your plans to join us in Asheville at the Omni Grove Park Inn (GPI). Or reserve your favorite seat in your own home for a weekend of comprehensive virtual sessions you will not want to miss.

Under the leadership of Program Chair Dr. Thomas White and Program Vice-Chair Dr. Katherine Haga, this year’s agenda is thoughtfully crafted to balance rigorous and

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requested clinical education with ample time for rest and relaxation. General sessions will run from 8 a.m. to 4:30 p.m. each day, providing in-person and virtual attendees with valuable insights into the latest advancements, treatment protocols, and practical applications you can begin using right away. With over 30 CME credits available, the Winter Weekend is an excellent opportunity to meet your year-end CME requirements while enhancing patient outcomes and streamlining your practice.

Mainstage presentations by expert guest faculty include updates in diabetes management, hypertrophic cardiomyopathy, advancements in treating obesity, managing hyper- and hypothyroid disorders, rare and secondary causes of hypertension, post-MI and stroke care, maximizing adolescent well-visits, vaccine uptake strategies for older adults, asthma

The North Carolina Family Physician

treatment selection and assessment, the latest in preventive care and wellness for women, the latest on contraception, opioids, and pain management, pharmacological advancements for insomnia, spirometry for the family physician, shockwave therapy, distinguishing between different tremors, practical tips for reading CT scans, ultrasounds, and MRI results, dermatology in pictures, taming administrative burden, the latest on vitamins and supplements, not-to-miss fractures in all ages, medical coding, and much more!

In-person attendees will enjoy networking events, social gatherings, and optional CME workshops and seminars.

Workshop highlights include a pre-conference Heart Disease KSA on Wednesday, Dec. 4, a hands-on auricular acupuncture workshop and a diabetes workshop on Thursday, December 5, along with a practice management seminar and a workshop featuring case studies in osteoporosis prevention and management on Friday, Dec. 6. Medical students and Family Medicine residents will also benefit from several educational opportunities and business meetings designed for their needs. All medical students, residents, and new physicians are invited to the networking social on Friday afternoon, and residents can look forward to the annual Residents Career Fair on Saturday.

The always-bustling exhibit hall is an excellent opportunity to network, learn, and discover innovative solutions to enhance your practice and patient care. Be sure to visit and engage with the many great supporters and companies that help make everyone’s favorite annual “Family Medicine tradition” possible by connecting with them and exploring their latest updates in medical technology, pharmaceuticals, and practice management tools. Expect terrific and thoughtful booth giveaways and a chance to win one of three $75 Amazon gift cards by participating in the exhibit hall.

With the hybrid registration option, those unable to be in Asheville over the weekend can still join us online for an unbeatable CME opportunity featuring the mainstage sessions. The virtual sessions will be accessible only during their scheduled times; later, on-demand viewing for CME credit will not be available. Optional workshops, seminars, and socials are only available with in-person registrations. In-person attendees will also receive web links to access virtual sessions, ensuring they do not miss any valuable content while in Asheville. All sessions are scheduled for Eastern Standard Time, and registration rates are the same for in-person and virtual attendees. For those attending in person, private links for making hotel reservations will be provided in your registration confirmation email. Only registered conference attendees may reserve rooms in the NCAFP’s discounted room blocks at the Omni Grove Park Inn (host hotel) and the Renaissance Asheville Downtown (overflow hotel).

On behalf of the NCAFP, we are excited to celebrate your dedication to Family Medicine this December! Whether you join us in-person at the Omni Grove Park Inn or participate virtually from home and in your pajamas, we are committed to providing an exceptional CME experience designed to support you and the critical work you do for your patients and communities. We look forward to being with you soon … wherever you may be!

Complete conference details, including the schedule of events, registration rates, and hotel information, are available now at www.ncafp.com/wfpw. Please contact me at katkinson@ncafp.com with any questions.

While the CME sessions are always top-notch and super-rewarding, Saturday evening’s Presidential Gala is another standout of this long-awaited weekend. Come dressed in your holiday best and join us for a gourmet dinner prepared by the GPI’s top chef. We will celebrate Family Medicine leaders by installing our 2024-2025 Board of Directors and inaugurating our new NCAFP President, Dr. Mark McNeill. Plan to capture the excitement and the memories with colleagues, family, and friends at our Gala photo booth and dance the night away to music from our favorite award-winning DJ, Mr. Mike Brooks.

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The North Carolina Family Physician

ADVISORY

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CAPITAL INSURANCE

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Contact Peter Graber with the NCAFP at pgraber@ncafp.com

ADVOCACY & OUTREACH

NCAFP Members Bring Family Medicine to the General Assembly for White Coat Wednesday

By Kevin LaTorre Communications and Membership Manager

On May 1, over 40 NCAFP members descended upon the General Assembly in Raleigh for meetings with their legislators, advocating for their profession and their patients.

While meeting with their lawmakers, NCAFP members stressed the need for increased investment in primary care, discussed how family physicians are burdened by unnecessary administrative tasks, and thanked lawmakers for policy advances like increased medical student loan repayment and expanded Medicaid. “All these issues impact health care access,” NCAFP Executive Vice President and CEO Greg Griggs said.

The number of attendees was the largest in memory for an NCAFP-sponsored White Coat Wednesday event, and many attendees came for the first time. “I’m not really a policy person, but I can see that it’s important to my practice that we’re here to talk with policymakers,” said Dr. Catherine Lok, a new physician from Asheville.

NCAFP Members Began New Relationships and Maintained Previous Ones The group met at the North Carolina Medical Society,

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where staff discussed the positives of making good first impressions and developing lasting relationships with lawmakers. “Primary care is the solution for the policy problems we need to solve,” NCAFP General Counsel Shawn Parker stated during the early morning briefing. “That’s why your representatives want to hear your stories and insights as family physicians.”

“It’s all about the relationship,” said Greg. “I like to call family physicians the trusted health care advisor for patients, and they can earn the same trust from their legislators.”

Many participants had attended White Coat Wednesday before and looked forward to speaking with the lawmakers they had met in previous visits. Dr. Benjamin “Frankie” Simmons, NCAFP Secretary-Treasurer, recalled that he’d met the legislative aide of a member of the General Assembly last year and that they have kept in touch: “He has my phone number now, and we have been texting and emailing about laws since then. We can’t discredit meeting a legislative aide.”

The North Carolina Family Physician

Anisa Eshraghi, a fourth-year medical student graduating from Campbell University’s Osteopathic School of Medicine to begin her Family Medicine Residency at Duke University’s School of Medicine, met with Sen. Dan Blue (D-14) for the second time. “I wanted to prioritize meeting with Sen. Blue because we have a relationship from last year, when we talked about the need for new primary care investment” she said. “Today we had another good conversation about how Family Medicine is unique in the state. He’s very easy to talk with.”

In their meetings, NCAFP members explained how Family Medicine can bolster North Carolina health care through reforms that interested several lawmakers.

Everyone’s first meeting happened on the lawn between the Legislative Building and the Legislative Offices Building, where Sen. Mike Woodard (D-22) welcomed the group and thanked them for their good work as family physicians. The attendees then met with their senators and representatives across nearly 30 meetings and reiterated how family physicians could best serve North Carolinians with greater primary care investment, relief from the administrative burden they face, and new ways to attract and retain future family physicians.

causes,” Dr. Wallace said.

“It sucks the joy out of caring for patients,” added Dr. Fruth.

Meanwhile, Dr. Jessica Triche found common ground with Rep. Keith Kidwell (R-79) on student loan repayment and reforming the barriers that family physicians face from prior authorizations. “We had a 30-minute meeting that went over time,” said Dr. Triche, “and he wanted to keep talking and asked for my card. It was a very productive meeting, and hopefully we’ll stay in touch. These meetings at White Coat Wednesday are always good for that.”

“Our members are the best voice of Family Medicine,” said Greg. “Patients have to trust their personal physician, and it is important that our lawmakers also trust family physicians. White Coat Wednesday is the first step in building that trust. As a result of our visit, 40 more family physicians, residents, and medical students are one step closer to becoming trusted health care advisors for our legislators.”

Please see some of these meetings on page 16! *A previous version of this article appeared online at ncafp.com in May 2024.

When Dr. Jeffrey Hamm met with Rep. Donnie Loftis (R-109) and Sen. Brad Overcash (R-43), he learned that they shared a lot in common. For one thing, Dr. Hamm knows Sen. Overcash, since they’re neighbors. For another, Rep. Loftis helped establish the Gaston County magnet school where Dr. Hamm graduated. “He was really excited to see that I became a doctor in Gaston County,” Dr. Hamm said. “And he’s very open to helping family doctors.”

When Sen. Graig Meyer (D-23) met with Dr. Joanne Fruth, Dr. Robin Wallace, Moriah Barker, and University of North Carolina medical student Hannah Hulshult, he heard first-hand how administrative burden harms both patients and primary care in North Carolina. “I know program directors whose residents don’t want to practice Family Medicine because of the burnout that admin burden

Summer 2024

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Dr. Garett Franklin and Dr. Joanne Fruth.

Moriah Barker and Maebelle Mathew with Rep. Allen Buansi.

NCAFP members with Rep. Dr. Kristin Baker and Rep. Dr. Tim Reeder.

NCAFP staff visiting Clinton Medical Clinic with representatives from UnitedHealthcare.

Dr. Catherine Lok and other members walk toward the legislature.

Drs. Lisa Cassidy-Vu, Deanna Didiano, and Joanne Fruth.

NCAFP members with Sen. Rachel Hunt.

Dr. Regina Bray Brown and Anisa Eshraghi with Sen. Dan Blue.

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Dr. Katherine Haga and other members with Rep. Carla Cunningham.

Dr. Joanne Fruth and Dr. Robin Wallace meet with their representative.

Dr. Jeffrey Hamm meets with Rep. Donnie Loftis.

The North Carolina Family Physician

NCAFP members with Sen. Julie Mayfield.

NCAFP members on the lawn of the General Assembly.

Olivia Fehrmann and her fellow members.

Dr. Lisa Cassidy-Vu and other members with Rep. Amber Baker.

NCAFP members on the lawn of the General Assembly.

Mark Bushhouse, Dr. Tanner Moore, and other NCAFP members.

Dr. Julia Ceglenski and Dr. Zachary Fisher with a fellow resident.

Dr. Garett Franklin, Greg Griggs, and others with Sen. Jim Burgin.

Dr. James Kouris and Dr. Benjamin Simmons.

Greg Griggs, Robert Brown, and Ryan Taylor at the ACOFP Annual Meeting.

Shawn Parker, Dr. Deanna Didiano, and other members at lunch in the legislative cafeteria.

Summer 2024

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Members and Greg Griggs at dinner during the ACOFP Annual Meeting.

Dr. Karen Smith, Dr. Chuck Rich, Dr. Benjamin Simmons, and other members at the office of Rep. Richard Hudson.

Marie Polanco during our visit to Hodges Family Practice.

Dr. Gregory Sawin, Dr. Margaret Helton, and other members visiting Washington, DC.

Dr. Robert Agnello with student members.

NCAFP General Counsel Shawn Parker (second to the left of the podium) during his FSMB installation ceremony.

Three Wilmington Family Medicine residents in front ofthe U.S. Capitol.

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NCAFP members visiting the U.S. Capitol.

NCAFP members during legislative visits in Washington, DC.

Rep. Deborah Ross with Dr. Garett Franklin and other NCAFP members.

The North Carolina Family Physician

Greg Griggs with AAFP Board Chair Dr. Tochi Iroku-Malize.

Dr. Robert Agnello with his family.

NCAFP members at the U.S. Capitol.

Dr. Robert Agnello delivering his ACOFP address.

Greg Griggs with Aryanna Thuraisingham and Colleen Yang.

Dr. Thomas White prepares to deliver the May 2024 Virtual DOT Medical Examiner Training.

Dr. Brian Kessler, Aryanna Thuraisingham, and others at the ACOFP Annual Meeting.

Dr. Chuck Rich, Dr. Benjamin Simmons, and other NCAFP members visit the office of Rep. Richard Hudson.

Social event during the ACOFP Annual Meeting.

Dr. Robert Agnello and others at the ACOFP Annual Meeting.

Summer 2024

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MEMBERSHIP SERVICES

By Kevin LaTorre

NCAFP Communications & Membership Manager

~ MEMBER SPOTLIGHT ~

Stacey Blyth, MD

Now, Dr. Blyth cares for her patients but also supports her fellow family physicians as the LeBauer Medical Director.

During her years in Tarboro, Dr. Blyth took up plenty of leadership roles because they were necessary and she was capable. “There was more work than bodies to do it,” she says. “So when they need someone to run the rehab floor at the hospital, you do it. When they need someone to help with the health department, you do it. When you’re asked, you help where your skillset allows. And I got tremendous job satisfaction out of all those roles.”

Dr. Blyth works as a family physician at LeBauer HealthCare in Greensboro.

She also serves as LeBauer’s Medical Director of Primary Care and Medical Co-Director of Primary Care at Cone Health Medical Group.

Dr. Blyth knew well before medical school that Family Medicine served the whole patient.

Dr. Blyth met several family physicians in Seattle, where she grew up.

“They were brilliant and could work anywhere because of their skillsets,” she says. “I always admired their commitment and intellect, and I always knew I was going to practice Family Medicine. I never considered anything else.”

Before Dr. Blyth attended medical school, she worked for two years as a teacher for children in foster care. That job cemented her need to practice whole-patient care as a family physician. “The work really solidified the fact that the psycho-social part of medicine was the whole ball game,” she says. “I knew then that I had to be willing to take on the messy social aspects of patients, and Family Medicine meets that part better than anything else.”

After Dr. Blyth had completed her medical school and residency in New York, she arrived with her husband and young children to begin practicing in Tarboro, NC. “It was 2004,” she says, “and I chose Tarboro. It’s where we really fell in love with North Carolina.” And though Dr. Blyth moved to Greensboro in 2011, some of her Tarboro patients have continued visiting her for care. “They still want to see me, if you can believe that,” she says.

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really value that.”

Dr. Blyth has continued to mix up her schedule with different work since coming to Greensboro. In addition to seeing patients, she works as LeBauer’s Medical Director of Primary Care and as Medical Co-Director of Primary Care at Cone Health Medical Group. LeBauer and Cone Health aligned 25 years ago, so that LeBauer can have its employees in the larger system which provides resources and stability, while still operating with some of the autonomy of an independent clinic. “We’re a multi-specialty group,” Dr. Blyth says. “We can work very collaboratively within the larger system to care for our patients. It’s unique to primary care to have such close collaboration with sub-specialty colleagues, and I

But the value of collaborative primary care isn’t only in Dr. Blyth’s job satisfaction, she says: “If you look at the numbers, patients do better with closer collaboration across the care continuum. Our structure across multiple specialties in the end benefits our patients. I have everything to provide holistic care.”

In addition to enjoying the care she and her colleagues give patients at LeBauer, Dr. Blyth enjoys leading her team. “I’ve hired many members of my team and have great faith in them,” she says. “When I started working here, we had 28 providers, and now we’re up to 64. At this point in my career, I feel compelled to help lead my system to care delivery that’s more viable for my team and our patients. That’s why I’ve become a cheerleader for Greensboro: to help family physicians come practice here.” *A previous version of this article appeared online at ncafp.com in May 2024.

The North Carolina Family Physician

ADVERTORIAL

Financial Health, Personal Well-Being Go Hand-in-Hand for Family Physicians

By Paul Hain, MD, FAAP Professional life for family physicians these days seems to be as much about spreadsheets, software and staffing models as taking care of patients. All physicians are keenly aware that the business of practicing medicine has become more complex. That’s one reason why more doctors are taking steps to recognize and manage the sources of financial stress they face - for the benefit of their patients, themselves and their families.

It’s old news by now that family physicians are facing burnout in record numbers. You’ve probably seen the data points: Physician burnout rose to 50% in 2021, up from 44% in 2017, among those with 11 to 20 years experience, as reported in study published in the JAMA Open Network in October 2023.

The study found considerably higher burnout rates among female physicians and among primary care physicians With more primary care physicians leaving or retiring, and an inadequate pipeline of new doctors, the Association of American Medical Colleges projects shortages of up to 48,000 primary care physicians by 2034 More often than not, surveys of physician job satisfaction point to the business challenges brought on by our complex and evolving ways of delivering and paying for care in the United States. These hurdles - financial, administrative, staffing, billing, coding, IT, EHRs - are the ones that physicians often cite as making their jobs more difficult. They’re present no matter what business model you’ve chosen, whether you’re an employed physician, an independent, or in partnership with other doctors.

discussions. Much of what takes place at NCAFP gatherings offers continual learning on such things as business models and practice operations, not to mention sharing personal stories with each other. The NCAFP Member Satisfaction and Practice Environment Committee helps with practice effectiveness as well as physician health and wellness, among other duties in its charter.

Likewise, the AAFP offers a wealth of resources and educational opportunities on practice management. These include big-picture items such as choosing business models for your practice, and operational details like revenue cycle management and accurate billing and coding. As the AAFP notes, these resources are useful for all family physicians, even employed physicians who aren’t accountable for day-to-day operations.

In our work at Alo, we often have conversations with independent practice owners who want to position themselves for a better future but aren’t quite sure how to get there. Inevitably the topic of value-based care comes up.

We tend to advise physicians on proceeding with VBC on the basis of what’s right for them given where the practice currently sits on the continuum of risk. This might mean, for example, that we discuss the benefits of being in a clinically integrated network (CIN) and accountable care organization (ACO) at the same time. Or we might explain why just being in the CIN makes the most sense for now.

It would be one thing if these challenges could be easily defined and managed. That’s just not the case. Every business and operational decision currently comes in an environment that’s not exactly hospitable to physician practices, as costs keep rising and reimbursement isn’t keeping pace.

It’s true that family physicians have more business and financial choices than ever. It’s a long list that includes: outsourcing administrative functions, signing value-based care agreements, securing outside investment, merging with other practices, selling outright to - or breaking off from healthcare systems, closing the practice, and maintaining status quo. You might even opt for a combination of these models.

Nearly nine in 10 medical groups saw their operating costs increase in 2023, with an average increase of 12.5%, according to a survey by the Medical Group Management Association.

These topics are crucial. But they’re far from the only ones that come up.

The business of medicine is highly personal, I think more so for family physicians than other specialties.

And we all know about the recent 3.4% cut to the conversion factor in Medicare’s physician fee schedule.

Experienced doctors want to know they’re building a legacy of outstanding patient care and maybe even doing so for several generations of families that they serve. Those who have recently started their careers are eager to make a difference in the profession, and it’s hard to do that if you’re constantly worrying about whether your practice can survive financially. I personally enjoy getting to know the history and motivations within our physician community across the state, which only helps as we’re trying to advise on business decisions.

Of course, business matters are just one set of challenges for family physicians. Another comes from the daily stress of delivering care, although for the vast majority, this takes a back seat to the satisfaction of serving patients and families, helping them get the best possible care when they need it. This is when family doctors are in their element. It’s why they went into medicine in the first place.

Fortunately, the family physicians here in North Carolina that I speak with understand the importance of seeking out and using a variety of resources to help them thrive - both professionally and personally - in the face of challenging circumstances.

Staying active in professional associations, for example, is one way physicians find support in ways that go beyond clinical and research

We all want assurances that what we’re doing professionally matters.

While different from the commitment to patient care, ensuring that your practice is financially healthy and that you as a family physician are personally healthy also require commitment. Physicians who take time to evaluate their options and make good choices on both of these fronts can look forward to a sustainable future focused on serving their patients and their communities.

Paul Hain, MD, FAAP, is Chief Clinical Officer at Alo. Headquartered in Durham, Alo provides strategic services and solutions to help North Carolina physicians manage the business of medicine.

MEMBERS IN THE NEWS

Two NCAFP Members Nominated for the AAFP Board!

This past May, Dr. Reid Blackwelder, Chair of the AAFP Nominating Committee, announced that the committee has nominated two NCAFP members for national leadership on the AAFP Board: Dr. Karen L. Smith as a candidate for President-elect and Dr. Shannon Dowler as a candidate for an AtLarge Board member position. Both doctors are past NCAFP presidents and celebrated Family Medicine leaders in North Carolina.

Now, Dr. Smith and Dr. Dowler will campaign throughout the next few months for the chance to be elected and installed at the 2024 AAFP Congress of Delegates in September.

Congratulations to them both!

NCAFP President Dr. Garret Franklin Discusses Administrative and Workforce Reforms in The Triangle Business Journal On June 21, NCAFP President Dr. Garett Franklin and NCAFP Exec.

VP and CEO Greg Griggs appeared as expert sources in The Triangle Business Journal article by Connie Gentry, “Primary Concerns: Burdensome administrative tasks and rising medical school debt are just two of the reasons doctors are staying away from family medicine.”

Together, they described the administrative burden, student debt, and underinvested primary care that make Family Medicine more unwelcoming than it should be. “We’ve ended up with doctors doing paperwork instead of taking care of patients,” Greg said. “We talk about having an access problem for primary care in the state, but if we took some of this administrative burden away and invested in the right things, physicians could have access to more patients.”

also described his medical school debt as another obstacle that is too common among students, residents, and practicing physicians. But many of you already know these problems well. And Dr. Franklin and Greg made sure to describe the solutions that the NCAFP is currently pursuing to correct them: “We want to drive investment in primary care; address the administrative burden, paperwork and documentation that hinders doctors’ lives; and get more medical students to come into family medicine as well as keep the doctors that are there,” Dr. Franklin said. Our efforts to introduce medical students to Family Medicine received a special mention. “The NCAFP Foundation has a $6 million campaign underway to continue recruiting medical students into family medicine,” the article states.

We’re thrilled to see Dr. Franklin and Greg share their insights into the ways that our state and insurance payers can help improve Family Medicine with the Triangle Business Journal. We’re also glad that they and the rest of NCAFP leadership continue to share those same insights with our lawmakers, payers, health systems, and other key stakeholders.

Dr. Chuck Rich Named Founding Division Head of Family Medicine at New Methodist University Cape Fear Valley School of Medicine NCAFP member and past president Dr. Robert L. “Chuck” Rich, Jr., has been selected as the founding division head of Family Medicine at the Methodist University Cape Fear Valley School of Medicine! Dr. Rich received both the news and the congratulations from fellow NCAFP member Dr. Hershey Bell, Founding Dean at the medical school: “We are all excited to invite you to our leadership team. Thank you for your willingness to serve!”

Dr. Rich will help Dr. Bell and the rest of the medical school’s leadership prepare its curriculum, faculty, and environment for the first class of medical students in 2026.

Given his experience as a Family Medicine leader in North Carolina and nationally, he is more than qualified to do this good work.

They described prior authorizations as one example of the over-administration of Family Medicine, but Dr. Franklin

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The North Carolina Family Physician

Dr. Winona Houser Named Employee of the Year at Cherokee Indian Hospital Authority In June, the Cherokee Indian Hospital Authority (CIHA) announced that NCAFP member Dr. Winona Houser was named Employee of the Year. Dr. Houser received the prestigious award alongside other recipients of various CIHA awards, and all recipients were honored as “individuals within our organization who exemplify our core values—integrity, responsiveness, teamwork, and innovation—and who have made significant contributions to the safety and quality of the healthcare services we provide,” according to the CIHA statement.

In discussing specific’s about Dr. Houser’s award, the CIHA statement could not have been more complimentary: “Dr. Winona Houser has consistently demonstrated exceptional dedication to patient care, embodying the highest standards of integrity and compassion in her role,” said CIHA staff.

“Dr. Houser’s outstanding contributions span various facets of hospital operations, from patient care to mentoring and education. Her commitment to excellence not only enhances patient outcomes but also strengthens our community.”

Dr. Adam Goldstein Received Distinguished Award from UNC NCAFP member Dr. Adam Goldstein received the Distinguished Faculty Award during the Spring Medical Alumni Weekend in May, according to the University of North Carolina (UNC) School of Medicine. Dr. Goldstein is the Goodwin Distinguished Professor at the medical school and the director of the UNC Tobacco Intervention Programs. His interdisciplinary research on tobacco communication and regulatory science has earned plenty of funding, publications, and influence. In addition, Dr. Goldstein has led and participated in several state, national, and international boards of medical leadership, while also finding time to serve on medical missions in Haiti, Moldova, Argentina, Israel, Ukraine, and other countries.

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NCAFP Secretary-Treasurer Dr. Benjamin Simmons Receives 2024 Advocate Health Excellence in Diversity Award Dr. Benjamin “Frankie” Simmons received the 2024 Advocate Health Award for Excellence in Diversity! “I am honored to be nominated and chosen among 103 nominees for the 2024 Advocate Health Excellence in Diversity Award,” Dr. Simmons said in a statement. He received the award for his long-time and ongoing work toward resolving health disparities and ensuring health equity for LGBTQ+ patients.

This achievement is no surprise to anyone who knows Dr. Simmons and his priorities as a physician and advocate.

Congratulations, Dr. Simmons!

Summer 2024

Wroth

Wells

Three NCAFP Members Named in Business North Carolina 2024 Power List for Health Care Leaders In its “2024 Power List” this past spring, Business North Carolina named three of our members (pictured left to right) as leaders in our state’s health care community: Dr. Cristy Page, Dr. Tom Wroth, and Dr. Roxie Wells!

Dr. Page currently works as the executive dean at the UNC School of Medicine, where she has helped increase the school’s research funding while also overseeing training of future family physicians for the good of the rural North Carolina communities where she herself has worked. Dr. Wroth, CEO at Community Care of North Carolina, was included for his leadership of “the state’s largest independent primary care practice partner.” And Dr. Roxie Wells serves as the Chief Physician Executive Officer at Novant Health, where she impacts the entire health system to benefit her fellow physicians and patients.

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RESIDENTS & NEW PHYSICIANS

What Comes Next for Graduating NC Family Medicine Residents

By Dr. Morgan Parker NCAFP Board Resident Director

To my fellow North Carolina Family Medicine Resident Graduates, Congratulations on this new milestone, one of so many during our medical training! After sitting through ceremonies from preschool onwards, I have assured my wonderful parents that this should be the last graduation they will be asked to attend. After many years of training, we are finally released to make independent decisions about how we will best serve our patients (hopefully in North Carolina!). The choices are many, and the need for our skills has never been greater. I’m grateful to have served as your Resident Director-Elect and Resident Director on the NCAFP board, an experience that has opened my eyes to the demonstrable difference that united family physicians make in their communities.

My mother was a public-school teacher in our eastern NC county, and growing up, I would hear her lament that those making decisions about classroom policy and curriculum had often never set foot in a classroom as a teacher themselves. As a physician, I feel similar frustration with some current health care policies, when decisions made by others affect my patient encounters and the intimacy of our office visits. My desire for a seat at the table — to add a small voice to the cacophony of insurers, federal and state policymakers, and health-corporation MBA’s — inspired my involvement in NCAFP. As a first-year medical student in Virginia, I attended an FMIG meeting for the free chicken sandwich and came away deeply impressed with both the scope of Family Medicine and the social needs that primary care offices can bridge. A few years later, I was selected as a student director to the board of the Virginia Academy of Family Physicians, though at its board meetings I didn’t understand half of the acronyms used or topics discussed.

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As a resident in North Carolina, I first attended a White Coat Wednesday event and couldn’t believe the access to state legislators we have as their constituents. Attending more events like that one solidified my fascination with building relationships with policymakers, in hopes of better advocating for ourselves and our patients across the state.

Continuing to attend also built my confidence to influence policy change. And now, when I’ve attended NCAFP board meetings, I understand more of the acronyms and find I have more to add to the conversation. I leave these meetings invigorated by the cooperative problem-solving, by the many accomplishing what individuals only dream of, and by the experienced physicians passing down wisdom to the newly-minted ones.

This year’s graduation has most of us leaving behind residency cohorts, faculty, and familiar academic settings. I’m going to miss charting next to my peers and the camaraderie of passing long hours of shifts under fluorescent hospital lighting (hear me: I’ll miss the camaraderie, not the shifts).

I have seen our class show resiliency—from starting our first intern months during the Omicron wave of COVID-19 to every in-basket message and overnight shift that have brought us to graduation this summer. I know that the NCAFP was working just as hard for us during those years, and I am grateful that the NCAFP will continue to support us, provide meaningful ways for us to learn through CME, and help us feel not quite so alone as we strike out on our new adventures.

I encourage you to stay connected to one another and nurture your personal and professional relationships – those are important foundations for your overall well-being. One way to stay involved is to simply update your contact information through your AAFP profile to help the NCAFP stay in touch as you move into practicing Family Medicine.

Another great way is to consider becoming a mentor to a medical student interested in Family Medicine. Or you can attend the Winter Family Physicians Weekend in Asheville this December, to take in the CME, professional camaraderie, and beautiful views. Whichever direction you head next, know that there will be a group of wise and thoughtful family doctors at your side, advocating for you and celebrating the milestones to come.

Dr. Parker served on the NCAFP Board from 2022 to 2024. She began practicing at Cary Medical Group in Cary after finishing her residency earlier this summer.

The North Carolina Family Physician

STUDENT INTEREST & INITIATIVES

What I Learned at the 2024 Boone NCAFP Summer Program

By Taylor C. Ellis, MS-2 at the Wake Forest University Bowman School of Medicine

I did not know until I was in college that I would pursue a career as a physician. As the first person in my family to pursue this path, I was confused and overwhelmed by applying to medical schools. I found the lack of accessible health care in the county where I grew up incredibly frustrating, and so my motivation to apply to medical school stems from my interest in providing accessible, comprehensive care in a primary care setting.

I was born and raised in a small, rural town east of Raleigh. I graduated from Bunn High School before earning my associate’s degree from Wake Technical Community College and my bachelor’s degree from North Carolina State University.

During my time in college, I worked for several years as a medical assistant at a multi-specialty clinic in Raleigh that offered Family Medicine, internal medicine, gynecology, pediatrics, and gastroenterology. I enjoyed getting to know multiple members of one family who were all patients at our practice. These interactions further drew me to primary care, since I would love to be able to build long-lasting physician-patient relationships, get involved with public health initiatives, and see a variety of patients and conditions as a physician.

Through the NCAFP’s 2024 Summer Rural Health Experience in western NC, I was able to confirm my love for Family Medicine by immersing myself in two different residency programs over the course of two weeks to live and work with doctors at those programs. Along with three other medical students, I spent the first week at Mountain Area Health Education Center (MAHEC) Boone, shadowing the residents in the hospital and in the outpatient clinic, as well as participating in lectures and workshops like the LGBTQ health session, the wilderness medicine session, and the ru-

Summer 2024

ral medicine session. One of my favorite days was when the program participants, residents, and attendings spent the day at Grandfather Mountain and at an alpine roller coaster. I loved interacting with everyone in that relaxed setting.

During my second week, I worked with residents and attendings at MAHEC Hendersonville, where I shadowed, interviewed and presented patients. I also observed procedues and even got to perform my first pap smear!

I discovered the endless possibilities that are possible with Family Medicine: seeing patients of all ages, working in inpatient and outpatient settings, performing countless procedures, and advocating for at-risk populations in the community. I previously did not see myself practicing in a rural setting but after participating in this program, I am now very confident that I would love to apply to a rural Family Medicine residency with a smaller, community-based hospital.

I am so incredibly thankful to the NCAFP Foundation for hosting this program and the doctors who hosted and accommodated me with their busy schedules. This program felt like an amazing introduction to Family Medicine and a safe environment where I learned as much as I could.

This program solidified my desire to become a family physician and opened my eyes to the many possibilities that rural Family Medicine residencies offer.

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PRACTICE MANAGEMENT

Navigating the Ethical and Responsible Integration of AI in Clinical Practice Authors: Frank B. Meyers, JD, Mark L. Staz, MA, Humayun J. Chaudhry, DO, MACP

INTRODUCTION Artificial Intelligence (AI) holds tremendous potential for improving patient health and adding efficiencies and enjoyment to the careers and lives of family physicians. In fact, physicians are already Mark Stats Frank Meyers seeing benefits from incorporating AI into their practices that go beyond facilitating administrative tasks to collecting and analyzing data, interacting with patients, and providing clinical decision support. When incorporating AI into medical practice, it is important for physicians to recognize that AI is not intended to replace them in their role as caregiver to a patient or the primary source of responsibility for the patient’s well-being. Rather, physicians should view AI as a tool that assists them in optimizing the care they provide to patients.

To support physicians in the responsible and ethical incorporation of AI into medical practice, the Federation of State Medical Boards (FSMB) recently adopted policy guidance that clarifies roles and responsibilities regarding the use of AI with patients, and supports physicians in understanding how, if at all, their professional responsibilities change when providing care that is enhanced or supported by AI. UNDERSTANDING AI AS A TOOL AI in health care is designed to complement, not replace, the role of physicians. It should be viewed similarly to other

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medical tools, such as scalpels or electronic health records (EHRs), which aid but do not replace the clinician’s judgment and responsibility. It is essential that physicians choose AI tools wisely and verify their outputs to maintain high standards of care. Below are some key considerations physicians should follow when using AI tools in their practice.

EDUCATION AND CONTINUOUS LEARNING Physicians should stay informed about AI developments and understand their applications, benefits, and limitations.

Continuous education is vital for leveraging AI effectively while maintaining high standards of care. FSMB recommends that medical education at all levels should include training on AI and advanced data analytics. Online courses, workshops, and conferences are valuable resources that can help physicians stay current with AI advancements.

Additionally, peer-reviewed journals and medical associations often publish updates and guidelines on AI applications in health Dr. Humayun Chaudhry care which can serve as helpful updates or “refreshers” for physicians.

ACCOUNTABILITY AND HUMAN OVERSIGHT AI can significantly aid in clinical decision-making and administrative tasks, potentially reducing physician burnout. However, the ultimate responsibility for patient care remains with the physician. AI should be seen as a decision-support tool rather than a replacement for clinical judgment. Physicians need a strong rationale for following or deviating from AI recommendations, ensuring all decisions uphold the standard of care. Moreover, it is essential to document the rationale behind decisions made with AI support. This documentation not only ensures transparency but also provides a record that can be reviewed in case of any discrepancies or legal considerations.

INFORMED CONSENT AND DATA PRIVACY Transparency is crucial for maintaining patient trust.

Physicians should inform patients about the use of AI in their care, including the capabilities and limitations of the AI tools used. Consent should be obtained before AI

The North Carolina Family Physician

applications are used in patient care, ensuring patients are aware of how their data will be used and protected. This transparency fosters trust and ensures that patients are active participants in their care decisions. Discussing AI use during consultations can also help demystify the technology for patients, making them more comfortable with its application in their treatment.

MITIGATING BIAS AND ENSURING EQUITY AI systems can inadvertently perpetuate biases present in their training data. Physicians have a professional responsibility to identify and mitigate these biases to provide equitable care. Efforts must be made to ensure that AI benefits are accessible to all patients, particularly those from historically marginalized communities, to prevent exacerbating existing disparities. Regular audits of AI systems can help identify and correct biases. Collaboration with data scientists can also ensure that the AI tools used are as unbiased and as fair as possible.

PRACTICAL CONSIDERATIONS FOR FAMILY PHYSICIANS AI has the potential to transform health care and improve outcomes for patients. However, AI also poses new challenges and risks that require careful consideration by family physicians. In this section, we provide some practical considerations for family physicians who want to use AI tools in their practice.

Tool Selection and Use When selecting AI tools, physicians should ensure they are reliable and validated. Understanding the design, data sources, and outputs of these tools is crucial to assess their appropriateness for clinical use. Regular monitoring and updating of AI tools are essential to maintain their effectiveness and safety. Engaging with vendors to understand the intricacies of AI tools and seeking feedback from peers who have used these tools can provide practical insights and enhance decision-making.

Documentation and Verification AI can assist with clinical documentation, reducing the administrative burden on physicians. However, physicians must review AI-generated records for accuracy, as inaccuracies can lead to patient harm and accountability issues for the physician. AI tools should not be used as a substitute for thorough documentation practices but rather as a complement that enhances efficiency. Regular checks and balances should be implemented to ensure that AI-generated data is accurate and reflective of the patient’s condition.

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Interdisciplinary Collaboration Successful AI integration requires collaboration among health care providers, data scientists, and regulatory bodies. This interdisciplinary approach ensures that AI tools are developed and used in ways that enhance patient care while adhering to regulatory standards. Physicians should actively participate in interdisciplinary teams to provide insights into clinical needs and challenges. This collaboration can lead to the development of more practical and effective AI solutions tailored to specific medical contexts.

CHALLENGES AND FUTURE DIRECTIONS The rapid development of AI technologies presents challenges for regulators and health care professionals. The current regulatory framework is complex and evolving. Physicians and medical boards must be proactive in staying updated with regulatory changes and new AI developments. Collaboration with industry stakeholders and continuous review of AI policies will be necessary to address these challenges effectively. Establishing clear guidelines and best practices can help navigate the regulatory landscape and ensure that AI applications remain within ethical boundaries.

FSMB’s guidelines offer a roadmap for the responsible and ethical integration of AI into clinical practice. By adhering to these guidelines, family physicians can harness the benefits of AI while safeguarding patient welfare and maintaining their professional integrity.

CONCLUSION The incorporation of AI in health care promises significant benefits but also poses risks if not managed responsibly.

FSMB’s guidelines provide a robust framework for the ethical use of AI, emphasizing education, accountability, informed consent, bias mitigation, and ethical governance.

Family physicians must embrace these guidelines to enhance patient care and navigate the evolving landscape of AI in health care.

By integrating AI thoughtfully and ethically, physicians can improve patient outcomes, reduce administrative burdens, and ensure that the benefits of AI are realized without compromising patient trust and safety.

About the Authors:

Frank Meyers is the FSMB Deputy Legal Counsel; Mark Staz is the FSMB Chief Learning Officer; and Dr. Humayun Chaudry is the FSMB President and CEO.

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