AAFP Taps Veteran Family Medicine Advocate as Next CEO/EVP

Martin, the Academy's senior vice president for advocacy, practice advancement and policy, already is familiar to many AAFP staff members and family physicians, having served in that role since 2012. Before joining the Academy, Martin served more than a decade as director of government relations for the American Osteopathic Association.

"We found the best candidate right in our own backyard," said AAFP President Gary LeRoy, M.D., of Dayton, Ohio, in an email to members. "Shawn has become a nationally recognized expert on primary care delivery, payment and workforce issues. He is passionate about promoting the specialty of family medicine, reducing administrative burden for physicians and ensuring everyone has equal access to affordable health care coverage based in foundational family medicine and primary care. Shawn is a strategic thinker and leader with a clear vision for the future of family medicine and the role the AAFP can play going forward."

It's been a busy few weeks for Martin, who -- in addition to accepting this promotion -- recently turned 50 and completed his master's degree in health care delivery science from Dartmouth College in Hanover, N.H. Now he'll move from the Academy's Washington, D.C., government relations office to its Leawood, Kan., headquarters.

He will continue serving in his senior vice president's role until June 1, and then will work alongside Henley as CEO designee during a transition period until Henley's retirement on Aug. 1.

AAFP News sat down with Martin to discuss his new role, his vision for the Academy and the challenges ahead.

Q: You grew up in rural Oklahoma as the son of a family physician. How did your father's medical career shape your understanding of primary care and your interest in health policy?

A: I saw at a young age the impact that a single physician, or a group of physicians, can have on individual patients and on a community. The burden on primary care was real even in the 1970s and '80s. We were isolated, far from the big health care centers in Oklahoma City or Tulsa. People relied on my father and the other primary care physicians in our county for the majority of their health care. I saw the capability that existed in family medicine to be comprehensive and deliver care in the traditional cradle-to-grave sense. I also learned the importance of access to health care in ensuring a thriving and sustainable community. Beyond that, as thousands of our members tell us, it is not easy to go into an underserved rural community and practice family medicine. Seeing my father dedicating his life to that every day for years has made a lasting impression on me.

Q: You've been focused primarily on governmental advocacy for more than 20 years in leadership roles with both the AOA and the AAFP. What motivated you to take on this broader role?

A: I've spent all of my adult professional career working in and around health care policy at the convergence of policy and politics. But I've always had other responsibilities in both of the organizations I've worked for. I've described it as being kind of a public brand ambassador for the organizations because I've played a role in communicating or collaborating with other people in the health care sector -- employer groups, insurance companies, etc. I've come to those responsibilities through a government relations or health policy position, but I've had the opportunity to engage in a broader set of activities around the organization and its mission inside and outside of the political arena. The mission of the AAFP and working with our members are two things that really motivated me over the past eight years and will continue to motivate me in the future. There is an incredible amount of opportunity that exists for family medicine. Our future -- as a discipline -- can be whatever we want it to be.

Q: The Academy has only had five executive vice presidents -- two who were physicians and three from executive backgrounds -- in its 73-year-history. What are the challenges of following in the footsteps of people like Robert Graham, M.D., and Douglas Henley, M.D.?

A: The Academy has always had strong leaders. The organization is structurally and financially sound. It has highly motivated staff, enthused members and enormous market share. All those things point to the fact that the organization has had really good leaders over a long time period. There is pressure to perform. You don't want to be the one who breaks that trend of success. Bob Graham and Doug Henley are two exceptional leaders who both happen to be family physicians, so they brought a perspective to their tenures that I won't. I've never seen a patient, never done a residency and never taken a patient history. But I bring a different perspective of understanding how the health care system functions. I understand how to create a better world for those who do practice family medicine. I understand the relationship between family physicians and everyone else in the health care system. Although I will not bring practice experience, I do bring policy, advocacy and corporate affairs experience to the position.

One thing I would stress about Bob and Doug is that they are both exceptional leaders. Irrespective of the fact that they're family physicians, they have leadership traits they would have if they were attorneys, accountants or anything else. I'd like to think I can grow into the kind of leaders and people they are.

Q: The Academy's leadership has been going through a period of transition with the hiring of a new CFO last year, now a new CEO, and longtime COO and deputy EVP Todd Dicus, J.D., plans to retire early next year. You also will be involved in finding your own replacement in the Academy's Washington office. How will you approach the opportunity to make two hires that potentially could influence the Academy and family medicine for years to come?

A: The addition of Charlotte Kerner, C.P.A.,to our executive management team as CFO and senior vice president for finance and administration was an important hire. CFO is a foundational pillar of any organization. The departure of Todd Dicus and Doug Henley, in a short time period, is going to be challenging. We're going to lose 20-plus years of institutional knowledge from two people who have shaped the history of our organization for a long time. The bright side, if you will, is we have created an organizational structure that allows for the empowerment of division directors and staff to take ownership of their work and ownership of innovation within the organization. Innovation doesn't reside in the C-suite. It resides in our divisions and among our staff. We'll continue to see tremendous growth and new products and services that provide value to members moving forward. The Academy will change. There's no doubt. But I've never been one to think change is bad. It's an opportunity to evaluate what you're doing, how you're doing it, why you're doing it and think about whether there is a better way moving forward.

Q: What are your short- and long-term priorities in your new role?

A: There are three things I spend a lot of time thinking about: being strategically focused, organizationally disciplined and structurally aligned with the first two issues. We have a good strategic plan. We have good strategic objectives. That will allow us to create value for members, create a health care system that is foundational in family medicine and primary care and allow patients to gain access to the benefit of comprehensive, continuous, coordinated family medicine and primary care. We're developing an operational plan that will help us be disciplined and align our human and financial resources to that strategic plan. That's an important endeavor we have started in the past year. It will be a point of emphasis moving forward.

Q: The Academy has advocated for increasing the percentage of health care dollars invested in primary care. How can your experience in Washington help family medicine move the needle in that direction?

A: My experiences in Washington are part of me. My view of the world is shaped by the reality I've existed in for the past 20 years. I understand that audacious goals meet political reality and financial reality pretty quickly -- sometimes in a really rude introduction. That doesn't mean there's not work we should do or there's not work that's worthy of pursuing. When we think about payment and investment in primary care, one of the things people are going to hear from me a lot is that our product is family medicine, and we need to be talking about the value of family medicine more aggressively. Part of that is paying family medicine more, and part of that is putting family medicine in a better position to be successful. We need to remove barriers from family physicians and allow them to do what they're best at, which is providing care to patients. We also need to make sure purchasers and payers are prioritizing family medicine and that government agencies understand the value of family medicine. We need to talk about the value of family medicine more and in different ways. My Washington experience will help us do that. We do it now, but as we move into the next generation of health care reform and we reimagine the health care system with more members being employed, we need to add value for all members regardless of their practice setting or location.

Q: Administrative burden is another area members are asking for help with. What are your plans to keep fighting against prior authorization and other barriers that are encroaching on the time family physicians spend with their patients?

A: Members identify administrative burden as their top frustration and their top priority for the Academy. We've initiated a lot of efforts aimed at reducing and eliminating administrative burden in its various forms. I've been pretty vocal in my blog and elsewhere that there was a failure in health care policy with respect to electronic health records and the HITECH (Health Information Technology for Economic and Clinical Health) Act. It's one of the few places in any industry where tech hasn't created efficiency. It's actually decreased efficiency in health care in many respects. It's a tragedy of policy-making that needs to be corrected. I don't think it means we get rid of electronic health records. I believe the digital collection, aggregation and distribution of medical information is an essential tenet of a 21st-century health care system. But we have to find a way to do this in a manner that doesn't detract from physicians' core function. We've all seen and heard stories that physicians are distracted and doing a lot of things besides actually listening and providing care to the patients in their exam room. Again, it's a real failure of health care policy that we are where we are today.

I also believe that rapidly transitioning away from fee-for-service and into new alternative payment models is important. Our health care delivery system is built around episodes, and those episodes each have complicated documentation and auditing requirements. Alternative payment models offer an escape from these legacy approaches to delivery and payment. The AAFP has been a national leader in the development, implementation and advancement of APMs, ranging from the Primary Care First and accountable care organizations programs to direct primary care. Each of these, while different from each other, is built on a new approach to delivery and payment that moves away from fee-for-service as the foundation. We have a lot of work to do in this area, but the AAFP leadership in this area is well established.

Q: A lot of members are familiar with you through your In The Trenches blog. Will you continue to write that, or will it be passed on to your successor in D.C.?

A: I enjoy writing the blog. It gives me an opportunity to dig into a topic. I'd love to keep writing it in some capacity. I don't know if I will post as regularly as CEO. I love the engagement with members. It's an opportunity to communicate with them and for them to vent frustrations and get things out in the open. There's a lot of value in that.

Q: Other thoughts?

A: I really look forward to working collaboratively with our staff in D.C., Leawood and around the country to ensure they have the direction needed and they feel empowered to do the good work we, as an organization, do every day. I'm also excited to work with our state chapter executives, who are dynamic leaders and partners, and the seven other family medicine organizations. It's a team sport.

Q: How do you feel about being 1,000 miles closer to your beloved Oklahoma Sooners?

A: I love Oklahoma. I've been away from Oklahoma for a long time, but it will always be an important part of me. I hope being closer means I can take in more OU games -- "Boomer Sooner"!