Dear Mr. President,

I have voted.  I have celebrated your election (in my own quiet way).  I have watched the festivities.  I am examining your opening days carefully to see what will change.  But I am left with a certain disquiet.

In the many news clippings surrounding your inauguration, I have heard almost every enthusiastic supporter remark, "Ok, today we celebrate, tomorrow it's time to roll up our sleeves and get to work!"

I am very excited about Secretary Daschle and hope his confirmation goes smoothly.  After hearing him speak at a recent EHR trade conference, I think he brings some wonderful and needed ideas to the government about leveraging technology for health care.  What I understand about your ideas for health care reform in the new administration includes an emphasis on primary care – and as a primary care physician – I am thrilled to hear this, but…

I am a plain old practicing family doc – granted, not a "real" one…I'm an academic family doc…but I try my best to act like a real family doc.  I do believe in the power of excellent primary care to save (yes, save) the health of the country and the health care system of the country.  I enthusiastically support you and your administration and want to help.  For the first time in my life, I'm truly motivated by what I see as the power of your administration to improve our country for the better.  I want to "get to work."

But I'm afraid I don't know what do. 

Yes, I can, should, and will keep on doing my best in what I do – helping to produce high-quality family doctors for the future, helping my patients take the best care of their health possible, and helping to figure out the answers to how to make primary care work better for our patients.  But I feel pulled to do more than just be able to compete for more AHRQ or HRSA funding for primary care programs and research (though that would be nice also, hint, hint).  I want to actively contribute to what I think is OUR (if I may be so presumptuous) vision for a better health care system.

So, I will continue to watch and look for a place where I can "roll up my sleeves and get to work" to make a real, transformative change in health care in the US.  Maybe I'll write a letter to a congressman.  Maybe I'll stumble upon something more significant to contribute.

Good luck, and I'll be hoping and watching.