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43 Daniel J. Ostergaard, Mindi K. McKenna, Elaine Kierl Gangel, and Penelope L. LaRocque chapter 4 The American Academy of Family Physicians Contribution to Continuing Medical Education The American Academy of Family Physicians (AAFP), founded in 1947, is one of the largest national medical specialty societies, representing more than 94,000 family physicians, family medicine residents, and medical students. Its vision is to transform health care to achieve optimal health for everyone, and its mission is to improve the health of patients, families, and communities by serving the needs of members with professionalism and creativity. The Influence of CME on the AAFP Vision and Mission The importance of continuing medical education (CME) was clear and embedded in the very origin of the AAFP. CME remains central to its organizational framework today. The AAFP, then known as the American Academy of General Practice (AAGP), was founded in 1947 to establish an organization of general practitioners of medicine and surgery to promote and maintain high standards of general practice and to promote the betterment of the public health. Its founders were committed to the concept of CME and its mandatory completion to better ensure the competence of its members and their ability to provide care for patients. One of the values of the AAFP and its members is a commitment to care that is supported by lifelong professional learning. Its original bylaws included a committee on education and, as of 2009, the AAFP bylaws contain a requirement for only three standing committees, one of which is a committee on education. Although other medical organizations have had similar initial goals, the AAGP was the first to require, as recorded in its original constitution and bylaws, that ‘‘a member each three years must complete 150 hours in postgraduate study of a nature acceptable to the board of directors.’’ At the time of the AAFP’s founding, some observers said the requirement for postgraduate medical education would prevent the AAFP from thriving because it represented a standard to which no other medical society aspired at that time. History has proved those naysayers wrong as the AAFP has flourished. Following World War II, the practice of medicine in the United States focused on technological advances gained during wartime, and far greater emphasis was placed on medical subspecialties devoted to the care of specific organs and organ systems.∞ General practitioners returning from the war faced daunting professional challenges; specialists received hospital privileges , higher incomes, and greater prestige that general practitioners did not. The change in both 44 organizations in early development American medicine and societal interest in technology caused student enrollment in general practice to decline. That decline was part of the impetus for the creation of the AAFP. Its tenacious pursuit of, commitment to, and reliance upon CME served as a means to maintain quality among general practitioners for the benefit of their patients. The Specialty of Family Medicine The 1960s saw a movement that gravitated away from general practice toward development of a new specialty: family practice. Nicholas Pisacano, MD, was the leader of this movement, and some vilified him for taking a position they thought would result in the creation of boundaries for the specialty. At that time, a certifying board for general practice did not exist, which was perceived as a hindrance to general practice training and residency programs.≤ After years of negotiations , the American Board of Family Practice (ABFP) gained approval in 1969 and joined other formal certifying boards that granted diplomate status. The formation of the ABFP (renamed the American Board of Family Medicine [ABFM] in 2005) was another demonstration of family practice leadership in CME. When the ABFP was chartered, its eligibility requirement of 150 CME hours every three years for family practice certi fication was unique. Additionally, the ABFP structure was singular among medical specialties in that it o√ered a time-limited certificate rather than ‘‘a specialist for life’’ recognition. Again, the educational requirements for family physicians were greater than those required for other specialties. In addition to the required 150 hours every three years, diplomates of the ABFP were also required to pass a secure examination every seven years in order to retain diplomate status; family practice was first in this requirement , but all other specialties have since followed. The AAFP Dual Role as CME Provider and Accreditor Family medicine has a demonstrated legacy of commitment to CME. In keeping with that tradition , the AAFP has been and continues to be a...

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