President’s Message: Committing to Health Equity

“Injustice Anywhere is a Threat to Justice Everywhere.”
– Rev. Dr. Martin Luther King, Jr.

Greetings, colleagues.  We hope you are as well as possible, as you help your patients and communities respond to Omicron. We honor your service: it is what family physicians do; it is important, and it is noble.

As we enter into a new year and reflect again on the legacy of Rev. Dr. Martin Luther King, Jr., ABFM recommits to addressing health equity across many dimensions.  It begins with our mission and vision: “Optimal health and health care for all people and all communities that family physicians serve.” More explicitly, we have committed to “including health equity into our program of lifelong learning and quality improvement,” as stated in our 2019-2025 Strategic Plan.  In this issue, I am pleased to share with you the progress that has been made since our September 2020 announcement regarding how ABFM would be addressing healthy equity and diversity/equity/inclusion (DEI).   You will also find stories that feature Diplomates and Residents and describe how they are improving health equity, as part of our new “Health Equity in Action” series designed to help you with your own improvement efforts.

Performance Improvement (PI) represents an opportunity for personal action to improve health equity. ABFM created the Health Disparities/Equity Self-Directed Clinical PI activity in mid-2020. This activity provides options for you to choose from, including addressing differences in clinical quality among groups of patients who have historically experienced disparities, developing an understanding of implicit bias among your staff, assessing barriers to equal access or equitable care delivery in your practice, or evaluating community-level assessments and interventions to manage social determinants of health. The Health Equity PI activity is modeled after the ABFM Self-Directed Clinical Project: Clinical Pathway activity, which means that it provides an opportunity for you to efficiently report on what you are already doing in your practice to address Health Equity and receive credit for that.

We are also committed to learning if there are any disparities among different groups of family physicians in their results on ABFM certification examinations. For the past eight years, we have collected data on Diplomate race and ethnicity and conducted Differential Item Functioning (DIF) analysis to assess whether bias exists in any of its examination questions. We have just published this analysis. While we have found some evidence of bias, it impacted relatively few questions (4 out of 3487).

And just recently, the ABFM research department, in partnership with the Robert Graham Center for Policy Studies in Primary Care and Family Medicine in Washington D.C., launched a multi-year policy brief series that explores equity and diversity in family medicine and the workforce. These will be published in the Journal of the American Board of Family Medicine (JABFM), with the first one being released in the January-February 2022 special issue.

Finally, ABFM is committed to enhancing the diversity of volunteers who help inform and prepare all certification activities, including item developers, exam reviewers, Engagement Network members, and our Board of Directors.

As you review these updates, we hope that you will take advantage of the new activities available to help you in your practice. We are eager to hear from you about ways that we can enhance our work in Health Equity.  Please reach out to us with ideas, concerns, or comments at [email protected]

We will continuously review and improve our certification activities, with the intent of supporting you in your efforts to reduce health inequities and provide equitable care to all patients and families that you serve.  As we did in September 2020, as we do now, we commit to transparency. We will continue to report back.

Warren Newton, MD, MPH
President and CEO