2012 Strategic Environmental Assessment by jrz43651


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									        2009 – 2012

       Strategic Plan

           of the

     American College of
Osteopathic Family Physicians

                                 For Presentation to the
                        ACOFP Congress of Delegates
                    March 3-4, 2009 in Washington, DC

                             Table of Contents

Strategic Planning Process……………………………………………………………..Page 3

Mission & Vision………………………………………………………………………Page 4

Desired Future for the Profession and for the ACOFP…………….…………………..Page 5

Environmental Assessment…………………………………………………………….Pages 6-9

ACOFP Strategic Goals………………………………………………………………..Pages 10-12


                             Strategic Planning Process

The following strategic planning process and timeline were established to research, develop and finalize
the 2009-2012 ACOFP Strategic Plan.

February 2008           E-mail survey of ACOFP members

March 10, 2008          ACOFP Board conducts SWOT analysis

April 17, 2008          Board’s Strategic Planning Subcommittee meets

May 22, 2008            Board reviews and edits initial draft of Strategic Plan

October 26, 2008        Board reviews comments and finalizes Strategic Plan, integrates into 2009
                        ACOFP proposed budget.

November 14, 2008       Comments on draft Strategic Plan requested of ACOFP state societies and other
                        key constituencies, with comments due January 9, 2009.

January 31, 2009        Board considers constituent comments and finalizes plan for submission to
                        Congress of Delegates

March 4, 2009           Endorsement of Strategic Plan by ACOFP Congress of Delegates

Strategic Plan Development & Implementation

The 2008-2009 ACOFP Board of Governors is primarily responsible for development and initial
implementation of the Strategic Plan.

Ronnie B. Martin, DO, FACOFP dist.               President
Jan D. Zieren, DO, MPH, FACOFP dist.             President-elect
Kenneth A. Heiles, DO, FACOFP dist.              Vice President
George T. Sawabini, DO, FACOFP                   Secretary/Treasurer
Steven F. Rubin, DO, FACOFP dist.                Immediate Past President
Thomas N. Told, DO, FACOFP dist.                 Past President
Larry W. Anderson, DO, FACOFP dist.              Governor
Kevin V. de Regnier, DO, FACOFP                  Governor
Jeffrey S. Grove, DO, FACOFP                     Governor
Carol L. Henwood, DO, FACOFP                     Governor
Paul A. Martin, DO. FACOFP dist.                 Governor
Rodney M. Wiseman, DO, FACOFP                    Governor
Stephanie G. Meissen, DO                         Resident Academic Member
Erica L. Johnson, OMS IV                         Student Academic Member
Mark E. Sikorski, DO, FACOFP                     Speaker, Congress of Delegates

                                     Mission Statement
The mission of the American College of Osteopathic Family Physicians (ACOFP) is to promote
excellence in osteopathic family medicine through quality education, visionary leadership and responsible

                                      Vision Statement
The American College of Osteopathic Family Physicians will strive to:

1. advance the health of patients and improve the health care system in the United States,

2. provide a foundation for quality medical education of students, residents and osteopathic family
   physicians as well as other primary health care providers in scientifically-based medical practices
   while advancing osteopathic principles and practices,

3. gain appropriate recognition for the contributions of osteopathic family physicians to the health of
   this country, including professional recognition, respect and economic rewards,

4. advance the appreciation of primary care in general and osteopathic family medicine in specific
   through its efforts with Colleges of Osteopathic Medicine, osteopathic family practice residency
   programs, other medical specialties and the public, and work to increase interest in the profession
   among medical students and residents,

5. strive for excellence in osteopathic family medicine residency programs through continuous quality
   improvement efforts and the development of innovative programs, thus advancing the recruitment of
   more osteopathic graduates into osteopathic family medicine resident programs,

6. be quality guardians of the resources of its members and use them to the maximum benefit of
   osteopathic family physicians, and

7. develop collaborative partnerships with other patient, osteopathic and primary care organizations to
   advance the health of the nation and the status of its osteopathic family physicians.


                     Desired Future for the Profession
                     of Osteopathic Family Medicine
1.   Advance the health of the population of the United States by providing patient-centered, timely,
     quality, primary care health care in a cost effective system.

2.   Advance the health care system of the United States by development of a patient-centered health
     care system with access for all.

3.   Achieve overall recognition and respect for the contribution of osteopathic family medicine
     physicians among all stakeholders, specifically with organizations that are collaborating on
     development of the Medical Home concept.

4.   Become the specialty of choice among osteopathic medical school graduates due to the
     opportunity to improve the lives of patients, the health care system and advance the personal lives
     and careers of physicians.

5.   Become the Graduate Medical Education training program of choice for osteopathic medical
     students who are interested in primary care.

6.   Improve the quality and expand the number of osteopathic family medicine residency programs.

                  Desired Future for the
     American College of Osteopathic Family Physicians
1.   Achieve recognition as the preeminent organization representing and advocating for osteopathic
     family physicians, their patients and osteopathic medicine.

2.   Have osteopathic medical students recognize osteopathic family practice residency programs for
     their excellence and for the diversity of career opportunities.

3.   Have 100 percent of osteopathic graduates who select family medicine for their specialty match
     into osteopathic family practice residency programs, and have 100 percent of AOBFP-certified
     osteopathic family physicians be ACOFP members.

4.   Be recognized as the resource of choice for maintenance of professional competency, licensure
     and continuous certification, excellence in its CME programs and excellence for the advancement
     and expansion of professional privileges, skills, competencies and reimbursement for osteopathic
     family physicians.

5.   Achieve financial independence, stability and the resources required to advance the priorities of
     the members and the ACOFP mission, vision and goals.

6.   Be respected as a collaborative partner and contributor by all government, public and private
     stakeholders for efforts to advance patient health and improve US health care systems.

                             Environmental Assessment
Factors in the External Environment

Medical Services - With more than 49 million uninsured and an anticipated 75 million patients being
enrolled in the federal Medicare program and an additional 16 million covered by the shared state and
federal Medicaid program by the year 2020, the demands on the medical system appear to have reached a
position that will direct significant changes in the health care system of the United States. Currently
spending more than $2.6 trillion dollars annually, the United States ranks 37th in the world in overall
measure of health for its citizens and 19th out of the 19 industrialized countries measured in the
Commonwealth Survey. If the United States adopted a patient-centered, primary care approach to
medical care in contrast to its current market driven, disease-oriented approach, it would not have the
providers needed to care for all of the potential patients.

Supply/Demand – more osteopathic and allopathic physicians will graduate from an expanding number of
medical schools with increasing class sizes. A declining percentage of graduates will select primary care
specialties, including osteopathic family medicine, due to economic and lifestyle preferences, and
perception of family medicine compared to other specialties.

Residency Training Positions – Presently, there are a sufficient number of osteopathic family medicine
residency positions to meet the demands of the graduates from Colleges of Osteopathic Medicine who
desire to enter family medicine programs. However, with more than half of osteopathic graduates
desiring to enter family medicine programs selecting allopathic residency programs, unfilled osteopathic
family practice positions are in jeopardy of being eliminated. Increased numbers of allopathic graduates
seeking residencies endanger future osteopathic physician opportunities for GME positions. Many
osteopathic family practice residency programs lack the structure sought by current graduates and suffer
from inadequate funding, facilities and faculty, especially full-time faculty. Increasingly, a higher
percentage of female graduates are entering osteopathic family medicine residencies, placing new
demands for structure and services on the programs that many have not adjusted to nor are prepared to

Payment – financial pressures continue to threaten the economic viability of family medicine practices in
the current market driven, procedure-based, disease-oriented health care system of the United States.
Many of the health improving services and cognitive services delivered by primary care providers are not
reimbursed or are reimbursed at inadequate levels. Also, increases in income have not matched
increasing practice costs or educational expense, making family medicine less attractive as a specialty to
graduates and current practitioners, as well.

Health policy experts and government-sponsored studies indicate that any solution to the nation’s health
care access and quality issues must be rooted in primary care, and there is growing recognition that the
value of services provided by primary care physicians must be reevaluated and improved. The
investigation of the medical home concept and quality performance programs all allow for increased
recognition of the profession and it physicians.

Practice Transformation – all medical practices, including those of osteopathic family physicians, will be
required to make significant business and operational transformation within their practices within 3-5
years through emerging demands for open access, electronic communications, expanded availability,
outcome evaluations, requirements for electronic medical records, and documentation of patient quality
and safety. Many small and underfunded practices will have difficulty meeting the requirements that are
anticipated by the National Committee for Quality Assurance (NCQA), payers and patients.

The cottage industry of family medicine is in danger of corporatization and absorption into larger medical
enterprises. Practices in rural and underserved settings are especially in danger due to financial
considerations and critical mass of patients available to the practice to support the changes indicated.

Practice Erosion – direct competition for practice rights with physician assistants, advanced practice
nurses, the emerging doctor-nurse movement, expansion of privileges for pharmacists, physical therapists,
chiropractors and other traditional mid-level providers places pressure on the practice of osteopathic
family physicians and on the development of the health care teams that are projected for future practices.
Patient groups are demanding expansion of access, cultural competency, personalized patient-centered
approaches to medical care and increasingly are accepting care from groups of professionals other than
physicians. Payers are increasingly paying for such services. In addition, other medical specialists
continue to attempt to degrade the practice and privilege rights for primary care providers as they
themselves come under competitive forces and economic challenges, including the hiring of midlevel
providers and lobbying for procedural privileges for their agents that they wish to deny to primary care

Factors in the Internal Environment

Membership – ACOFP membership continues to exhibit a 1-2 percent net decline annually in spite of
increased absolute numbers of osteopathic graduates entering family medicine residency programs,
reflecting the actions of Generation X and Millennium Generation physicians as well as the increasing
number of osteopathic physicians seeking GME in allopathic residency programs, then joining allopathic
organizations. The demands on physicians’ time, stressed economics for family physicians compared to
previous decades, the emergence of more employed physicians, the demands for personal time and
lifestyle quality issues all contribute to declining membership in organizations across the professional
spectrum. The ACOFP is challenged to maximize its market potential by developing the values that will
attract and retain the growing number of female physicians and residents who are entering family
medicine residencies and the practice of medicine. Despite these negative factors, ACOFP membership
can be described as “stable” in the short term.

Industry Funding – economic support for educational programs from industrial partners, particularly the
pharmaceutical industry, continues to deteriorate and be under scrutiny from multiple observers. As a
result, CME program support for our face-to-face educational meetings is anticipated to continue to
constrict. In addition, the demand for increased on-line and interactive educational events from our
members is growing and ACOFP is striving to meet the demands.

Reputation – ACOFP leadership and staff have favorable reputations with the general membership, state
society leadership, and leaders at the AOA and other specialty colleges.

Communication – ACOFP has not found an effective strategy to deliver its mission and vision to its
members and the greater public. Currently, communications are not distinguishable in a manner that
allows the content of its messages to be clear among the expanding number and types of print and
electronic communications. Engaging members in a meaningful way will be more difficult, but it is one
task for which the ACOFP leadership and staff must achieve success.

Finances – ACOFP finds itself in a continuously stressed economic condition. In spite of a 95 percent
increase in annual dues over the past 10 years, dues revenue has not demonstrated a similar increase due
to declining membership. Expenses have increased at a rate exceeding inflation due to demands for
additional service and electronic communications with membership. By all current indicators, industry
funding will continue to constrict. Sources of non-dues revenue to date have not been successfully

located or developed. Financial constraints endanger ACOFP’s ability to provide desired benefits and
services to its members or to expand its activities with new initiatives. The ACOFP currently maintains
financial reserves that meet the standards demanded by the Board of Governors, but which may exceed
prudent requirements, possibly making reserves available for significant special projects and initiatives
for membership benefits.

Osteopathic Family Physician News – The changing methods of communication desired by our members
coupled with declining industry support continue to bring pressure on continuing traditional magazines
and printed forms of publications. OFPN currently is a significant drain on ACOFP resources and has no
immediate potential to reach a budget neutral or profitable status. It is not currently approved by Index
Medicus, thereby limiting its ability to raise advertising revenue. The lack of advertising revenue limits it
ability to compete for scientifically-based articles that would allow it to meet the requirements of Index
Medicus, thus the “catch 22” in which the publication finds itself. The publication is well received by
membership and is an effective form of communicating with membership at this time.

Staff and Operations - The ACOFP has a stable staff of loyal and dedicated employees. It has enjoyed
comparable stability for the past eight years. However, as the size of the organization’s membership
shrinks and funding declines, examination of all functions of ACOFP operations and the potential for
outsourcing of operations and services must be an ongoing process.

Conventions – decreasing margins due to tightened grant and industrial support and increasing convention
expenses place stress on the continuance of ACOFP-sponsored conventions and CME programs.
Declining membership, lower registration numbers for many of the meetings, more options for CME
including on-line and local programs, challenges faced by members for demonstration of continuing
competency and maintenance of certification all endanger the traditional CME programs and challenge
the ACOFP to present quality convention experiences that meet financial objectives. Examination of
restructuring of conventions and modification of traditional programs must be a component of ACOFP
strategic initiatives.

Findings in ACOFP Membership Survey

ACOFP conducted an on-line Membership Survey in February 2008. The survey was sent to 8,715
Active Members and received 605 responses, for a response rate of 6.9 percent.

The highest support for possible strategic initiatives was given to:

   A national campaign to educate the public about osteopathic family medicine and osteopathic family
   Education on practice management
   Education on electronic medical records
   Evaluation of electronic medical records systems
   Maintenance of certification policies and procedures

The lowest support was given to:

   Admission of MDs into osteopathic residency programs and eligibility for AOA certification
   Education and resources to transition to “medical home” concept of practice
   Participation in demonstration projects for quality/safety

Highly valued member benefits/services include:

   Advocacy to advance osteopathic family physicians, osteopathic medicine and their privileges and
   Maintaining Basic Standards
   CME programs and Intensive Review

Members increasingly seek CME via the web site and decreasingly seek information via fax or phone

A key assessment of the survey indicates that the membership is not well informed about changes
proposed in systems of medical practice that are being explored, including the Medical Home, pay-for-
performance and quality initiatives.

                                ACOFP Strategic Goals

Goal 1 – To develop and support programs that foster excellence in practice and delivery of
osteopathic family medicine, thereby improving the health status of citizens of the United States
and its health care system.

Implementation Actions:

A. Reform current standards, policies and procedures for graduate medical education to bring them more
   in line with the expectations and demands of the students and residents, thereby ensuring that they
   reflect and exceed the needs of practitioners in the next decade.

B. Advance faculty development in osteopathic family medicine and support for educators at Colleges of
   Osteopathic Medicine and in graduate medical education programs.

C. Develop and implement policies and procedures as well as the educational materials required to
   ensure maintenance of competency and allow for maintenance of excellence for physicians in

D. Advocate for health policy actions that advance the health of the citizens of the United States and
   advance the practice of osteopathic family medicine, and achieve recognition for the contributions
   made by osteopathic family physicians.

E. Provide programs that develop and promote leaders and innovative thinkers for the profession of
   osteopathic family medicine in Colleges of Osteopathic Medicine, residency programs and in

F. Provide programs that advance the professional skills and competency of osteopathic family

G. Provide programs that advance the business and financial interest of osteopathic family physicians.

H. Provide programs that educate and assist osteopathic family physicians in evolving their practices in
   keeping with anticipated changes in the health care system.

Key Responsibility:

Goal 2 – To achieve public and professional recognition of osteopathic family medicine, osteopathic
family physicians, and their contributions to the health of the citizens of the United States and its
health care system.

Implementation Actions:

A. Support ACOFP student chapters in their efforts to attract students to the profession of osteopathic
   family medicine.

B. Develop programs that support residents in their personal and professional development and that
   advance osteopathic family medicine and osteopathic family physicians.

C. Advocate for appropriate recognition, scope of practice and privileges along with health system and
   payment reform from public, private, state and federal regulators, payers and governments.

D. Work for tort reform to advance access to medical care, appropriate protection of patient rights, and
   health care for patients as well as the interests of osteopathic family physicians.

E. Work with the COMs and state affiliate organizations to make osteopathic family medicine and
   osteopathic family medicine GME programs the number one choice among graduates of osteopathic
   medical schools.

F. Advance the knowledge and improve the perception of osteopathic family physicians among all
   stakeholders, other specialists, COM faculty, students, patients and the general public.

G. Collaborate with other osteopathic organizations to develop and deliver a public relations campaign,
   promoting osteopathic family medicine, osteopathic leaders, and heros.

H. Partner with other stakeholders to promote osteopathic medicine, the profession of osteopathic family
   medicine and primary care, including but not limited to: AACOM, AOA, AAFP, ACOI, ACOS,
   ACOOG, AAO, ACOFP Student Chapters, ACOFP and AOA state affiliates, Auxiliary to the
   ACOFP, Advocates for the AOA, AAFP, ACP, AAP, governmental agencies such as HRSA, and
   patient advocacy groups such as AARP, NRHA, etc.

Key Responsibility

Goal 3 – To ensure that the ACOFP is operated effectively and efficiently, obtains maximum
benefit from the utilization of member’s resources, fosters growth, stability and security of the
association, addresses issues of concern among its members and the osteopathic profession, and
advances the ACOFP mission, vision and goals.

Implementation Actions:

A. Conduct a capital campaign to establish an endowment to support the ACOFP mission, vision and

B. Conduct critical analysis of all expenditures, including Board and staff functions, to ensure that the
   organization receives high return on investment and that all expenditures advance the ACOFP
   mission, vision and goals.

C. Conduct a membership campaign with specific targets for women and osteopathic residents to yield
   more member volunteers talent and fiscal resources that advance the ACOFP mission, vision and

D. Ensure that the organization is operated in a transparent and inclusive manner that encourages support
   and contributions from its members.

E. Evaluate all components of current programs such as OFP News, conventions, Intensive Update and
   on-line CME efforts to ensure that they are providing an appropriate return on investment, are
   meeting the needs and expectations of the members, and are advancing the ACOFP mission, vision
   and goals.

Key Responsibility

Goal 4 – To develop a comprehensive and effective communications process that involves, motivates
and informs the profession and the public.

Implementation Actions:

A. Improve the ACOFP web site and increase its use by students, physicians and the public.

B. Improve OFP News with a goal of achieving Index Medicus recognition and increasing it distribution.

C. Increase use of blogs and newsletters to inform and involve members.

D. Maximize the effectiveness of communications by aligning communication strategies with member,
   stakeholder and public expectations and needs.

Key Responsibility

Goal 5 – To implement reforms of the US health care system that result in the adoption of a system
that places its emphasis on the health and wellness of the patient and is founded on a strong patient
centered, primary and preventive medical care system.

Implementation Actions:

A. Work for the adoption of a patient centered primary care health system (Medical Home) in the US to
   replace the current inefficient and ineffective disease oriented, volume and procedure oriented

B. Work for tort reform to advance access to medical care, appropriate protection of patient rights, the
   health care for patients as well as the interest of osteopathic family physicians.

Key Responsibility

Goal 6 – To advance the practice knowledge and acumen of osteopathic family physicians and
improve the operations of their practices.

Implementation Actions:

A. Accelerate the adoption of health information technology and e-prescribing by osteopathic family
   physicians through education, implementation assistance and evaluation of current and evolving

B. Offer education and evaluation of business and practice systems that advance the health and
   satisfaction of the patients while improving the economic status of the physicians, including but not
   limited to group education systems, pay-for-performance systems, and quality outcome programs.

C. Provide for group business and professional advantages as a benefit of membership.

Key Responsibility


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