WEBVTT 1 00:00:02.080 --> 00:00:04.319 - There's a small circle of people who truly 2 00:00:04.319 --> 00:00:05.919 - understand what it takes to lead a health 3 00:00:05.919 --> 00:00:08.660 - system right now. The decisions are enormous. 4 00:00:08.960 --> 00:00:11.919 - The variables are constantly shifting, and the stakes 5 00:00:11.919 --> 00:00:14.099 - of getting a call wrong don't stay contained. 6 00:00:14.400 --> 00:00:16.904 - That's not a complaint. It's a structural reality. 7 00:00:17.204 --> 00:00:19.125 - And it's why the most effective c suite 8 00:00:19.125 --> 00:00:21.285 - leaders are deliberate about where they go to 9 00:00:21.285 --> 00:00:22.585 - pressure test their thinking. 10 00:00:22.964 --> 00:00:25.945 - Becker's fourteenth annual CEO and CFO roundtable 11 00:00:26.324 --> 00:00:28.564 - brings together more than 1,500 12 00:00:28.564 --> 00:00:29.864 - executive level attendees 13 00:00:30.239 --> 00:00:32.799 - and nearly 400 speakers for four days built 14 00:00:32.799 --> 00:00:34.739 - around growth, financial sustainability, 15 00:00:35.280 --> 00:00:38.079 - workforce strategy, and the leadership questions that don't 16 00:00:38.079 --> 00:00:39.140 - have easy answers. 17 00:00:39.679 --> 00:00:41.840 - Join us November second through the fifth in 18 00:00:41.840 --> 00:00:42.340 - Chicago. 19 00:00:42.799 --> 00:00:44.820 - For the agenda and event details, 20 00:00:45.195 --> 00:00:47.355 - visit beckershospitalreview.com 21 00:00:47.355 --> 00:00:49.195 - and click on the events tab in the 22 00:00:49.195 --> 00:00:49.935 - upper right. 23 00:00:50.715 --> 00:00:52.875 - This is Laura Dirdo with the Becker's Healthcare 24 00:00:52.875 --> 00:00:54.954 - podcast. I'm thrilled today to be joined by 25 00:00:54.954 --> 00:00:57.435 - Sean Martin, executive vice president and chief executive 26 00:00:57.435 --> 00:00:59.774 - officer at the American Academy of Family Physicians. 27 00:01:00.050 --> 00:01:01.090 - Sean, it's a pleasure to have you on 28 00:01:01.090 --> 00:01:03.329 - the podcast today. Laura, thank you so much 29 00:01:03.329 --> 00:01:05.189 - for the invitation. I'm looking forward to it. 30 00:01:05.489 --> 00:01:07.969 - Absolutely. Now I'm excited for our conversation. I 31 00:01:07.969 --> 00:01:09.569 - know there's a lot of great work that 32 00:01:09.569 --> 00:01:12.530 - you're doing, with the academy, and, certainly, we'll 33 00:01:12.530 --> 00:01:14.609 - be excited to learn more about some of 34 00:01:14.609 --> 00:01:15.015 - the, 35 00:01:15.575 --> 00:01:17.495 - initiatives that you're working on and successes you're 36 00:01:17.495 --> 00:01:18.775 - seeing as well as your focus for the 37 00:01:18.775 --> 00:01:20.694 - next few years. But before we dig in, 38 00:01:20.694 --> 00:01:21.814 - can you tell us just a little bit 39 00:01:21.814 --> 00:01:23.275 - more about yourself and your background? 40 00:01:23.894 --> 00:01:25.894 - Sure. So I'm a native of Oklahoma. Grew 41 00:01:25.894 --> 00:01:27.894 - up in rural Oklahoma. And, 42 00:01:28.534 --> 00:01:31.000 - after my education, I went to the graduate 43 00:01:31.000 --> 00:01:32.459 - school in New Hampshire and, 44 00:01:33.000 --> 00:01:34.760 - made my way to Washington DC, and I 45 00:01:34.760 --> 00:01:36.600 - really have spent most of my career working 46 00:01:36.600 --> 00:01:37.740 - for physician organizations. 47 00:01:39.000 --> 00:01:40.760 - I was a senior vice president at the 48 00:01:40.760 --> 00:01:43.980 - AFP, largely working on payment and workforce policies, 49 00:01:44.915 --> 00:01:47.954 - before I became CEO on 03/11/2020 50 00:01:47.954 --> 00:01:48.454 - and, 51 00:01:49.234 --> 00:01:51.875 - navigated the organization through the COVID pandemic and 52 00:01:51.875 --> 00:01:52.375 - then, 53 00:01:52.995 --> 00:01:54.834 - have been really honored to lead the work, 54 00:01:55.075 --> 00:01:57.655 - that we've been doing moving forward, since then. 55 00:01:58.609 --> 00:02:01.890 - Absolutely. What what a fascinating time to to 56 00:02:01.890 --> 00:02:04.450 - take the leadership role of the organization, and 57 00:02:04.450 --> 00:02:05.269 - I can imagine, 58 00:02:05.649 --> 00:02:07.569 - you know, a a lot of stories coming 59 00:02:07.569 --> 00:02:10.310 - through that time. But, you know, in in 60 00:02:10.724 --> 00:02:12.805 - the, interest of of focusing it on where 61 00:02:12.805 --> 00:02:14.004 - we're at today, could you give us a 62 00:02:14.004 --> 00:02:15.305 - state of the union for, 63 00:02:16.085 --> 00:02:18.085 - AFP? What has gone well this year, and 64 00:02:18.085 --> 00:02:19.284 - what do you focus on for the rest 65 00:02:19.284 --> 00:02:20.344 - of twenty twenty six? 66 00:02:20.645 --> 00:02:22.485 - Sure. Well, we, I thought the World Cup 67 00:02:22.485 --> 00:02:24.324 - went great. That's not really what you asked 68 00:02:24.324 --> 00:02:25.604 - me about, but I thought that was a 69 00:02:25.604 --> 00:02:27.789 - high bar mark for something that high watermark 70 00:02:27.789 --> 00:02:29.069 - for something that went well. 71 00:02:29.389 --> 00:02:31.150 - For us, I think I think we're really 72 00:02:31.150 --> 00:02:32.609 - pleased right now with the expansion 73 00:02:33.870 --> 00:02:36.189 - of primary care delivery models, particularly those that 74 00:02:36.189 --> 00:02:39.169 - are focused on independent practices. I think we 75 00:02:39.574 --> 00:02:41.334 - have been concerned for a while about the 76 00:02:41.334 --> 00:02:43.914 - pendulum swing as hospitals and health systems 77 00:02:44.775 --> 00:02:46.394 - began to rethink their 78 00:02:46.775 --> 00:02:48.694 - primary care strategies, but we're seeing a lot 79 00:02:48.694 --> 00:02:51.974 - of really solid investment in primary care, particularly 80 00:02:51.974 --> 00:02:53.674 - independent community based models. 81 00:02:54.060 --> 00:02:55.340 - And I think at the tip of that 82 00:02:55.340 --> 00:02:57.659 - spear is really direct primary care and direct 83 00:02:57.659 --> 00:02:58.159 - contracting, 84 00:02:58.780 --> 00:03:00.539 - which is creating a lot of opportunity for 85 00:03:00.539 --> 00:03:01.199 - my members, 86 00:03:01.500 --> 00:03:02.159 - to create, 87 00:03:03.020 --> 00:03:04.959 - new approaches to caring for communities 88 00:03:05.259 --> 00:03:07.500 - that are, you know, really aligned with the 89 00:03:07.500 --> 00:03:09.199 - core values of family medicine. 90 00:03:10.094 --> 00:03:12.435 - We continue to be heavily focused on affordability. 91 00:03:13.455 --> 00:03:16.254 - I think the affordability issue is the defining 92 00:03:16.254 --> 00:03:17.474 - debate of the next 93 00:03:18.094 --> 00:03:20.034 - six months to three years. 94 00:03:20.575 --> 00:03:21.635 - I think it will, 95 00:03:21.979 --> 00:03:24.299 - similar to 2008, emerge as a major issue 96 00:03:24.299 --> 00:03:26.299 - in the presidential election in a couple years. 97 00:03:26.299 --> 00:03:28.959 - And I I think like most organizations and 98 00:03:29.180 --> 00:03:31.019 - most CEOs, I'm spending a lot of time 99 00:03:31.019 --> 00:03:32.079 - thinking about that. 100 00:03:33.180 --> 00:03:34.780 - Got it. That makes a lot of sense. 101 00:03:34.780 --> 00:03:37.099 - You know, it is really helpful to understand 102 00:03:37.099 --> 00:03:39.275 - all of the different dynamics going on in 103 00:03:39.275 --> 00:03:40.655 - the health care space today. 104 00:03:41.594 --> 00:03:43.534 - So, you know, truly, truly interesting. 105 00:03:43.915 --> 00:03:46.075 - I'm curious as you're looking at, moving forward, 106 00:03:46.075 --> 00:03:48.314 - thinking about the independent practice, thinking about everything 107 00:03:48.314 --> 00:03:49.055 - else that, 108 00:03:49.754 --> 00:03:51.530 - is coming down the pipe. What are some 109 00:03:51.530 --> 00:03:52.810 - of the big headwinds that you're have your 110 00:03:52.810 --> 00:03:54.509 - eye on and are preparing for? 111 00:03:54.969 --> 00:03:56.569 - Yeah. I think there are three major ones 112 00:03:56.569 --> 00:03:57.849 - that I would share with you. I think 113 00:03:57.849 --> 00:03:58.990 - one is this, 114 00:04:00.250 --> 00:04:02.650 - kinda AI battle that's taking place in the 115 00:04:02.650 --> 00:04:04.110 - coding space where, 116 00:04:05.125 --> 00:04:05.625 - downcoding 117 00:04:06.004 --> 00:04:07.544 - by payers and, 118 00:04:08.004 --> 00:04:10.085 - you know, my members and others on the 119 00:04:10.085 --> 00:04:12.724 - kind of care delivery side using AI to 120 00:04:12.724 --> 00:04:13.224 - maximize 121 00:04:14.164 --> 00:04:14.664 - documentation 122 00:04:14.965 --> 00:04:16.264 - and coding. And, 123 00:04:17.139 --> 00:04:18.579 - I think it's just creating a lot of 124 00:04:18.579 --> 00:04:19.720 - tension, and, 125 00:04:20.740 --> 00:04:22.100 - I don't know that it's great. You know, 126 00:04:22.100 --> 00:04:24.019 - I I think it's just an economic headwind 127 00:04:24.019 --> 00:04:26.019 - that's really putting a lot of pressure, downward 128 00:04:26.019 --> 00:04:26.519 - pressure 129 00:04:27.220 --> 00:04:29.699 - on particularly smaller practices, but I I think 130 00:04:29.699 --> 00:04:32.105 - that concerns me. The other one for us 131 00:04:32.105 --> 00:04:34.185 - in the physician space is just the policies 132 00:04:34.185 --> 00:04:35.245 - around student loans. 133 00:04:36.024 --> 00:04:38.925 - It's it's creating a lot of financial headwinds 134 00:04:39.225 --> 00:04:41.004 - for medical students, residents, 135 00:04:41.944 --> 00:04:44.024 - new to practice physicians. There's a lot of 136 00:04:44.024 --> 00:04:46.819 - uncertainty about what is actually happening in the 137 00:04:46.819 --> 00:04:48.680 - policy space and regulatory space, 138 00:04:49.060 --> 00:04:51.139 - what it's gonna look like moving forward, and 139 00:04:51.139 --> 00:04:53.240 - how these physicians are going to, 140 00:04:53.620 --> 00:04:55.540 - you know, plan one to manage their debt, 141 00:04:55.540 --> 00:04:58.300 - but also two to, you know, create a 142 00:04:58.300 --> 00:05:00.420 - a financial pathway forward for them and their 143 00:05:00.420 --> 00:05:02.274 - families. And then the third one, again, I'll 144 00:05:02.274 --> 00:05:03.714 - come back to it. I think the the 145 00:05:03.714 --> 00:05:06.615 - economic headwind of just affordability of everything, 146 00:05:06.995 --> 00:05:07.735 - but affordability 147 00:05:08.035 --> 00:05:09.175 - inside health care 148 00:05:09.475 --> 00:05:11.794 - is much bigger than I think we realize, 149 00:05:11.794 --> 00:05:13.555 - and I think it's going to start to 150 00:05:13.555 --> 00:05:15.334 - become a really loud 151 00:05:16.259 --> 00:05:17.399 - national conversation, 152 00:05:17.939 --> 00:05:19.479 - more something it already is. 153 00:05:20.579 --> 00:05:22.180 - Got it. I I think that makes a 154 00:05:22.180 --> 00:05:23.779 - lot of sense. And, you know, to your 155 00:05:23.779 --> 00:05:24.279 - point, 156 00:05:25.060 --> 00:05:27.639 - the financial aspects of health care certainly 157 00:05:27.939 --> 00:05:29.139 - are ones that, 158 00:05:29.459 --> 00:05:31.305 - you know, are a challenging discussion have been 159 00:05:31.305 --> 00:05:33.465 - so, so necessary when you think about not 160 00:05:33.465 --> 00:05:33.965 - only 161 00:05:34.425 --> 00:05:37.625 - the health of, provider organizations, but also, you 162 00:05:37.625 --> 00:05:40.345 - know, what the affordability for health care will 163 00:05:40.345 --> 00:05:40.845 - be. 164 00:05:41.384 --> 00:05:42.985 - So when you look at the work that 165 00:05:42.985 --> 00:05:44.925 - you do, you know, with the 166 00:05:45.329 --> 00:05:47.730 - academy as well as, with legislators in Washington 167 00:05:47.730 --> 00:05:48.769 - DC, what are, 168 00:05:49.250 --> 00:05:51.169 - you know, is the tenure, I guess, of 169 00:05:51.169 --> 00:05:53.649 - the discussions there? Are you seeing movement in 170 00:05:53.649 --> 00:05:55.910 - the right direction when you connect with lawmakers 171 00:05:56.129 --> 00:05:56.790 - and policymakers, 172 00:05:57.169 --> 00:05:57.669 - or, 173 00:05:58.209 --> 00:05:59.990 - is it still kind of an uphill battle? 174 00:06:00.584 --> 00:06:02.024 - No. I mean, I think we're in a 175 00:06:02.024 --> 00:06:03.564 - good it's always an uphill battle. 176 00:06:04.264 --> 00:06:05.785 - But I think we're, you know, in a 177 00:06:05.785 --> 00:06:07.464 - good position. There's a there's a lot of 178 00:06:07.464 --> 00:06:08.685 - recognition of the value 179 00:06:09.704 --> 00:06:12.264 - of comprehensive and continuous primary care right now. 180 00:06:12.264 --> 00:06:14.685 - I think we see a lot of investment 181 00:06:14.745 --> 00:06:18.019 - of intellectual capital into making it better. 182 00:06:18.639 --> 00:06:20.259 - I think we actually see regulatory 183 00:06:20.639 --> 00:06:21.860 - movement. I thought 184 00:06:22.319 --> 00:06:24.800 - the Medicare physician fee schedule, while it has 185 00:06:24.800 --> 00:06:27.300 - some challenges, was a real signal, 186 00:06:28.204 --> 00:06:30.845 - a directional signal of greater investment in primary 187 00:06:30.845 --> 00:06:33.724 - care, both from a financial perspective, but also 188 00:06:33.724 --> 00:06:34.224 - just, 189 00:06:34.845 --> 00:06:37.324 - from a foundational perspective of making sure people 190 00:06:37.324 --> 00:06:40.139 - have access to comprehensive and continuous primary care. 191 00:06:40.379 --> 00:06:42.620 - So I I think, Laura, we we see 192 00:06:42.620 --> 00:06:43.600 - positive signs. 193 00:06:44.220 --> 00:06:45.980 - Positive signs have to be built, 194 00:06:46.460 --> 00:06:49.340 - into, you know, positive policies, but I I 195 00:06:49.340 --> 00:06:50.319 - think we are, 196 00:06:50.860 --> 00:06:54.000 - optimistic about our ability to, to do that. 197 00:06:54.955 --> 00:06:56.314 - That makes a lot of sense. And, you 198 00:06:56.314 --> 00:06:57.754 - know, thank you so much for digging a 199 00:06:57.754 --> 00:06:59.595 - little bit deeper there. Now when you look 200 00:06:59.595 --> 00:07:00.955 - over the next two to three years or 201 00:07:00.955 --> 00:07:02.574 - so, where are some of the best opportunities 202 00:07:02.634 --> 00:07:04.875 - to grow? What do you see, if you 203 00:07:04.875 --> 00:07:06.895 - look a little bit into your crystal ball? 204 00:07:07.419 --> 00:07:09.339 - Yeah. I I love this question. I I 205 00:07:09.339 --> 00:07:10.479 - think we're at, 206 00:07:11.579 --> 00:07:13.500 - you know, family medicine and primary care have 207 00:07:13.500 --> 00:07:16.060 - really had three renaissance errors, and I I 208 00:07:16.060 --> 00:07:17.819 - think we are, you know, looking at kind 209 00:07:17.819 --> 00:07:18.959 - of that fourth one. 210 00:07:19.595 --> 00:07:20.654 - I think comprehensive, 211 00:07:20.955 --> 00:07:21.455 - continuous, 212 00:07:21.915 --> 00:07:24.894 - AI supported family medicine and primary care models, 213 00:07:25.675 --> 00:07:27.595 - have a moment in front of them. And 214 00:07:27.595 --> 00:07:29.455 - and I think this concept of, 215 00:07:29.834 --> 00:07:31.995 - you know, like super primary care or the 216 00:07:31.995 --> 00:07:34.634 - super generalist as Bob Walker likes to call 217 00:07:34.634 --> 00:07:35.009 - it, 218 00:07:35.730 --> 00:07:36.710 - is not unrealistic. 219 00:07:37.170 --> 00:07:38.389 - And and I think 220 00:07:39.170 --> 00:07:40.629 - because of their capabilities 221 00:07:41.009 --> 00:07:43.170 - and and the the depth and breadth of 222 00:07:43.170 --> 00:07:45.650 - services that family physicians can provide in all 223 00:07:45.650 --> 00:07:46.629 - kinds of settings, 224 00:07:47.615 --> 00:07:49.535 - I think there's a moment for family medicine 225 00:07:49.535 --> 00:07:51.794 - to really grow in meaningful ways. And, 226 00:07:52.574 --> 00:07:54.334 - because they can be deployed to any care 227 00:07:54.334 --> 00:07:58.115 - setting, hospitals, communities, community health centers, independent practices, 228 00:07:58.975 --> 00:08:01.134 - they are unique in their ability to meet 229 00:08:01.134 --> 00:08:02.194 - the needs of 230 00:08:02.660 --> 00:08:04.980 - individuals, families, and communities, and I think we're 231 00:08:04.980 --> 00:08:07.060 - really eager to build that case and build 232 00:08:07.060 --> 00:08:08.600 - support systems around them. 233 00:08:09.620 --> 00:08:12.120 - I love that. You know, so such important, 234 00:08:12.899 --> 00:08:15.160 - reminders and ways to really, 235 00:08:15.685 --> 00:08:17.925 - think through what's gonna be most beneficial for 236 00:08:17.925 --> 00:08:21.064 - the patients and how to, leverage the technology 237 00:08:21.365 --> 00:08:22.264 - that is available, 238 00:08:23.365 --> 00:08:25.524 - to, you know, make some of those things 239 00:08:25.524 --> 00:08:27.764 - that were in the past, you know, a 240 00:08:27.764 --> 00:08:28.985 - dream into reality. 241 00:08:30.269 --> 00:08:32.590 - Now from your perspective, when you think about 242 00:08:32.590 --> 00:08:33.090 - leadership, 243 00:08:33.870 --> 00:08:35.549 - who is a leader that you admire really 244 00:08:35.549 --> 00:08:37.009 - from any industry and why? 245 00:08:37.870 --> 00:08:40.269 - I I I struggled here. I'm not really 246 00:08:40.269 --> 00:08:42.909 - admiring him right now, but I am spending 247 00:08:42.909 --> 00:08:44.850 - a lot of time reading Adam Grant. 248 00:08:45.345 --> 00:08:47.504 - And I've I'm actually have gone back and 249 00:08:47.504 --> 00:08:50.384 - reread his book Originals, and part of it 250 00:08:50.384 --> 00:08:52.464 - is is consistent with the conversation we're having, 251 00:08:52.464 --> 00:08:54.384 - Laura. I think he does a really interesting 252 00:08:54.384 --> 00:08:55.845 - job of framing up 253 00:08:56.225 --> 00:08:58.865 - how to look at old problems with new 254 00:08:58.865 --> 00:09:00.164 - solutions, and 255 00:09:00.559 --> 00:09:02.399 - that's kinda where my headspace is right now. 256 00:09:02.399 --> 00:09:04.240 - I I don't think these problems are new 257 00:09:04.240 --> 00:09:05.759 - to us. I think they've been around in 258 00:09:05.759 --> 00:09:07.779 - various forms for decades, and, 259 00:09:08.480 --> 00:09:09.299 - we have, 260 00:09:09.919 --> 00:09:10.899 - you know, taken 261 00:09:11.360 --> 00:09:13.759 - modest approaches to fixing them. But I I 262 00:09:13.759 --> 00:09:15.679 - think Adam does just a brilliant job of 263 00:09:15.679 --> 00:09:16.455 - talking about, 264 00:09:16.855 --> 00:09:19.174 - you know, how to take disruptive views that 265 00:09:19.174 --> 00:09:20.955 - hold problems and really 266 00:09:21.415 --> 00:09:24.054 - create new opportunities or new industries or new 267 00:09:24.054 --> 00:09:26.535 - products. And when I think about family medicine 268 00:09:26.535 --> 00:09:28.134 - and primary care, I'm thinking about how do 269 00:09:28.134 --> 00:09:29.894 - we disrupt and create a new version of 270 00:09:29.894 --> 00:09:31.434 - primary care or family medicine, 271 00:09:32.179 --> 00:09:34.419 - to meet the problems of today and tomorrow. 272 00:09:34.419 --> 00:09:37.299 - And so I I'm really enjoying rereading that 273 00:09:37.299 --> 00:09:39.700 - book, and, I admire him as a writer, 274 00:09:39.700 --> 00:09:41.059 - but I don't know that I admire him, 275 00:09:41.059 --> 00:09:42.579 - you know, in the way you're asking the 276 00:09:42.579 --> 00:09:45.075 - question. But that's where I'm spending my time. 277 00:09:45.875 --> 00:09:47.154 - Yeah. I know. I mean, I think that's 278 00:09:47.154 --> 00:09:49.554 - very helpful and and certainly a great context 279 00:09:49.554 --> 00:09:51.475 - when you look at, you know, where the 280 00:09:51.475 --> 00:09:54.115 - industry's at today and where an innovation can 281 00:09:54.115 --> 00:09:56.035 - come from. I think most leaders would agree, 282 00:09:56.035 --> 00:09:57.750 - you know, a lot of the the issues 283 00:09:57.750 --> 00:09:59.590 - they're going through are variations on a theme 284 00:09:59.590 --> 00:10:01.990 - or things that, have plagued health care for 285 00:10:01.990 --> 00:10:03.750 - a long time. And and so I love 286 00:10:03.750 --> 00:10:06.389 - that idea of being able to, identify some 287 00:10:06.389 --> 00:10:07.910 - of that and then the leaders who can, 288 00:10:08.230 --> 00:10:10.470 - think differently about it and disrupt in the 289 00:10:10.470 --> 00:10:11.210 - health justice. 290 00:10:11.574 --> 00:10:12.934 - Sean, thank you so much for joining us 291 00:10:12.934 --> 00:10:14.934 - on the podcast today. This has been a 292 00:10:14.934 --> 00:10:16.954 - ton of fun, a really great conversation, 293 00:10:17.334 --> 00:10:18.695 - and I look forward to talking to you 294 00:10:18.695 --> 00:10:20.954 - again soon. That sounds great. Thank you, Laura.