ABFM Outreach: A Strategic Approach to Creating Genuine Partnerships with Family Physicians

A positive, genuine, and effective relationship between the American Board of Family Medicine (ABFM) and the physicians participating in continuous certification over the course of their professional careers is essential for ABFM to achieve its vision of “optimal health and health care for all people and communities that family physicians serve.” In 2016 to 2017, ABFM’s Board of Directors had focused conversations around the fact that our duty to the public would be strengthened by viewing our duty to current and future Diplomates as a partnership. From this perspective emerged the belief that by increasing the understanding of the purpose of certification, making the process easier to access and complete, and improving the value of activities involved in continuous certification, ABFM could simultaneously assure physicians and the public that the credential represents a meaningful measure of professionalism, cognitive expertise, and commitment to improvement. But this new relationship, including meeting Diplomates where they were and listening more effectively, would require both a policy and administrative shift.

The policy change occurred with the development of the ABFM Strategic Plan 2019 to 2025 as these conversations were memorialized as 1 of 6 major goals: To Support Diplomates and Their Practices Across Their Careers. Administratively, this meant engaging with family physicians more broadly and with a greater in-person presence and establishing a role of Ombudsperson for Diplomate Experience within ABFM, which was filled by Dr. Elizabeth Baxley. To meet family physicians where they were, an intentional strategy was to seek closer partnerships with AAFP State Chapters, who serve as their professional “educational home.” Ms. Ashley Webb, who was selected to serve as the Director of Outreach in 2019, worked tirelessly to create important lines of communication with chapter leadership, seeking ways to be more present at chapter meetings and conferences, listening, and learning from their members, and offering one-on-one consultation to family physicians with questions about certification. This was particularly important given the number of improvements ABFM was making across the certification portfolio during this time, including the addition Family Medicine Certification Longitudinal Assessment, a new ABFM National Journal Club, and major revisions in both Knowledge Self Assessments and Performance Improvement activities.

A state chapter advisory group was formed in September 2018 which included staff from the AAFP and the executives from a broad group of chapters including Maryland, Illinois, North Carolina, Florida, Georgia, Texas, Ohio, Nebraska, Idaho and California. Meeting with this group was critical to better understand views regarding ABFM, to share what they hear from their members regarding board certification, and to consider ways that ABFM could build out an effective outreach and communication effort. Emerging from these conversations were several themes: 1) communication is improving – “the doors are open and let us keep them that way”; 2) local touch is important; 3) physicians still question the value of certification; and 4) there is still a lot of confusion about the process for achieving and maintaining certification. Chapters were enthusiastic to work with ABFM to educate and dispel common myths about certification, especially with regards to self-assessment and performance improvement options, and they expressed an openness to identifying additional ways to make these shared efforts and goals sustainable. ABFM prioritized greater involvement with state chapters through presence at their meetings and submissions to the AAFP sponsored state chapter executives’ newsletter. This also opened doors for ABFM to sponsor activities for chapter executives and staff at AAFP’s FMX, Annual Chapter Leadership Forum, and its regional chapter leadership clusters with representation from chapter staff and elected leaders across the country.

Beginning with a focus on “What Is New? What Is True? And What Is Ahead?” in-person updates were provided to chapters by ABFM leadership along with provision of a booth for answering questions, providing individual consultation to physicians attending the meetings, and listening to their perspectives and feedback on certification and its processes. These were catalogued and brought back to ABFM leadership, staff, and the Board of Directors to enhance understanding and to inform strategic and operational decisions. In total, ABFM had visited 35 state chapters in 2019 and early 2020, providing us the opportunity to reach family physicians across broad geographies and practice types. We appreciated the immediate benefit to being in person, which allowed for enhanced bidirectional communication, greater opportunities for directly assisting family physicians, and to establish the stronger relationships we sought.

The COVID-19 pandemic necessitated a pivot to quickly standing up virtual updates and opportunities for dialog. These were accomplished through both live sessions and prerecorded videos presented at multiple chapter meetings throughout 2020, as well as FMX, and the National Conference for Students and Residents. Virtual exhibits were also possible for FMX, the National Conference, and chapter meetings which provided an “informational booth,” surveys, and downloadable handouts. Resident-focused updates on initial and continuous certification were added and facilitated through chapters’ established statewide lines of communication to residency programs and Family Medicine departments.

The pandemic required us to think “outside the box” to continue to provide easily accessible resources to affiliates and Diplomates alike. Additional enduring materials were developed (videos, handouts) that could be accessed by state chapters, residency programs, and others to help bridge the knowledge gap about ABFM certification requirements and activities. A new website, Chapter Connect, was developed specifically for chapters as a 1-stop shop for information related to ABFM resources, chapter data reports, outreach opportunities, pilot materials, and support for conducting their own group Knowledge Self Assessments (KSAs) and adding chapter-sponsored Journal Clubs using the ABFM National Journal Club article assessments.

In 2022, we were able to return to in-person meetings, which are a far superior way to meet our goal of strengthening relationships with Diplomates. Still, we are not leaving virtual offerings behind as they allow additional, low-cost opportunities for bidirectional communication on a more continuous basis. Between the start of our outreach efforts and the end of this calendar year, ABFM will have engaged in 138 distinct outreach activities (Figure 1), but we are far from done. Future plans include expanding our effort to improve communication with more diverse groups, such as medical societies representing minority physicians, early and late career physicians, osteopathic physicians, subspecialty/CAQ holders, and Diplomates who are not AAFP members.

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Figure 1.

AAFP constituent chapter and other outreach by ABFM, 2019–present.

These early experiences with chapter outreach reinforced the value of developing strong relationships with family physicians as well as academic family medicine leaders and leaders of the other family medicine organizations. With support from the ABFM Board of Directors, a State Chapter Pilot Program was developed to create the opportunity for state chapters to request funding for new initiatives to advance work in areas which aligned with the major goals of the ABFM Strategic Plan. In the inaugural year, 11 chapters were funded for pilots which addressed a variety of topics (Table 1), culminating in an ABFM sponsored virtual Chapter Symposium in September 2021. This served a valuable purpose of sharing ideas and resources across all chapters. A second call for new chapter pilots was released in October 2021, with 5 additional chapters being added. Beyond financial support for these initiatives, ABFM supported these chapters with information, data, and speakers, and helped track their progress with phone calls and surveys throughout the pilot period.

Beyond the support for Chapters to engage in pilot projects that helped to meet their needs, these have also served a meaningful role that allowed ABFM to explore ways to further evolve and improve the experience of continuous certification for participating physicians. Some have tested the value of more formal linkages between learning and practice improvement. Others have informed ABFM’s work with residents and residency programs, which parallels our efforts to create educational materials for program directors and faculty regarding the value and process of certification. Several pilots had a focus on developing programming on health inequalities and DEI, which align with ABFM’s separate but related activities in this area. Finally, 1 pilot substantially influenced our development of the new MyABFM Portfolio, which was a key ABFM initiative focused on improving Diplomate experience and support by reducing the time it takes to understand and access certification activities while providing searchable FAQs for the most asked questions about ABFM certification.

The developmental work to create the MyABFM portfolio also helped to establish a new opportunity to learn from family physicians through both in-person and virtual focus groups, as well as individual user interviews and surveys. Occurring throughout 2022 to 2023, these focus groups provided feedback that informed our redesign of ABFM Knowledge Self-Assessments (KSAs); identified key features for including in the MyABFM Portfolio; helped to inform development of a personal Certification Planner; advanced ideas about establishing new communication preferences for Diplomates; and tested concepts for development of an ABFM Mobile App. Feedback has also been sought from residents and program directors, to help us plan improvements for the Residency Training Management system and to inform development of specific resources about certification for their use.

Much has been learned from ABFM outreach efforts. We see tangible ways in which our relationships with family physicians and family medicine organizations have become more positive and collaborative. Every conversation with a Diplomate informs the day-to-day work of ABFM staff as well as the deliberations of our Board of Directors, who have found them so beneficial that they themselves have sought opportunities to meet with family physicians for listening sessions hosted in conjunction with board meetings.

Communication, information transfer, seeking feedback, and growing collaborative relationships all serve to advance the ABFM Strategic Plan to Support Diplomates Throughout Their Careers. We are immensely grateful to the state chapter executives and physician leaders who have embraced our presence, provided us an opportunity to meet physicians in their local environments, and shared valuable insights that inform future planning. This is a critical partnership for ABFM, and we look forward to the opportunity build on these early successes to listen, learn, educate, and further strengthen our relationship with family physicians nationwide.