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Well, it is finally here—my first chance to address the ACOFP community from the President’s Desk. You would think with an extra six months to think about this, I would have been prepared with an eloquently written message to attest to my thoughts, plans and initiatives for the upcoming year. Ironically, this extra time has brought only more uncertainty, unrest and injustice on so many different levels.

As a mother, I manage the family calendar: birthday parties, school functions, swim practices, homework and “drama” that goes along with raising three girls. As a daughter, I am the primary caregiver for my mother, who suffers from dementia since the age of 60 and resides in an assisted living facility. As a wife, I am blessed to be married to the kindest, smartest, most selfless man who truly is my partner on every level.

As you are reading this, we are eight months into the COVID-19 pandemic in the United States. We have witnessed numerous protests in response to police brutality and the need for fair and equal treatment of minorities, specifically our Black communities. We have seen record high unemployment rates, bankruptcies of major businesses and a strain on our economy. We have seen the education of our medical students and residents disrupted, leaving us wondering if that lost clinical time can truly be replicated. We have seen frontline health care workers give everything they have and more, with too many succumbing to this pervasive virus. These are the unfortunate realities of 2020.

For those who do not know me well, I am a graduate of the Philadelphia College of Osteopathic Medicine and received my MBA in Health Administration at St. Joseph’s University while attending medical school. I completed my family medicine residency in the Philadelphia area at what was once called Frankford Bucks Hospital, a part of the Jefferson Health System.

As a clinician, I precept fourth-year medical students from Kiran Patel College of Osteopathic Medicine at NOVA Southeastern University in their rural and underserved rotation and family medicine residents at HCA Oak Hill Hospital for their inpatient family medicine blocks. As an advocate for our profession, I have had the honor of serving as the president of the Florida Osteopathic Medical Association and Florida Society of ACOFP— both preparing me for my position on the ACOFP Board of Governors and as your incoming president.

I moved to Florida in 2007 and have since been working in an Advanced Payment Model, taking care of Medicare Advantage patients in the outpatient and inpatient setting. In 2011, Brian Bixler, MD, joined our practice and it is no coincidence that our last names are now the same—we married in 2012. Together we have three beautiful daughters ages 9, 15 and 17.

And as a woman who is trying to manage it all, I hope I am getting it “right” and serving as a role model to my daughters and other females who are striving to find that balance between a professional career and motherhood.

To say that the year 2020 has thrown this highly motivated, multi- tasking planner for a loop is an understatement. With the help of my family and the dedication of the ACOFP Board and staff, March in New Orleans was set to be a fantastic annual convention. Over six months of preparation was upended by six days of immediate action planning to present a successful ACOFP ’20 Virtual CME program—minus the meeting of our Congress of Delegates, the launch of new presidential initiatives, the honoring of new fellows and the fellowship that is synonymous with our college and convention.

The newly formed Health and Wellness Committee and Task Force on Convention Innovation could not meet to lay out the groundwork for the year to come. The 70th Anniversary of the ACOFP could not be celebrated with a traditional Mardi Gras king cake. The Presidential Diversity, Equity & Inclusion Leadership Award could not be announced in conjunction with honoring the past presidents of the ACOFP. And a special tribute to women leaders in our profession will have to wait another year. Not to mention the thousands of Mardi Gras beads, masks, pralines and Zapp’s chips that were packed and ready to make the trip as part of a proper New Orleans presidential celebration.

I have to take this opportunity to publicly thank my ACOFP Board family and the continued leadership and kindness of our president, Robert DeLuca, DO, FACOFP dist., and our Executive Director, Bob Moore, for their support during that really tough week as we made that decision to cancel the in-person convention. But as the saying goes: “There’s no crying in baseball” (or maybe this year, there is crying for baseball as we knew it). Neither is there crying over your personal disappointments when you have children who need you to be their rock of support.

Who knew that March 13 would be the last day my daughters attended school for the year and we would all need to learn to adapt to online learning, separation from our extended families and peer groups, and months of existence in relative isolation. No matter how many years of education you have or how many leadership roles you have served, you cannot be prepared for the questions: “When can I go back to school?” “Why can’t I have playdate?” “Are you and Daddy going to get sick?” “Will we ever get to see Grammy again?” “Mommy, when will this virus ever end?” Those questions have made me realize that as important as ACOFP is to me and how unfortunate it was that my well-laid plans did not come to fruition, it paled in comparison to the devastating toll this year has taken on our collective families.

So, what lemonade have I made from all these 2020 lemons? For me, it has been a time to slow down, reflect and reconnect—a time to take longer evening walks, read a book for pure enjoyment, make family dinners, play a board game, go fishing and build forts in the family room. It’s an opportunity to be creative in providing traditional activities in a new socially distanced way.

Who would have thought an RV trip to a local campsite would be just as memorable as our family trips to Hawaii and Puerto Rico? It has given me a new appreciation for our educators and the patience they have in teaching our children. It has pushed our practice to adopt telemedicine to care for our vulnerable population. It has made us all examine our personal implicit biases and how we can do better as physicians.

As for ACOFP, it has exemplified how a dedicated staff, volunteer board and committee members can rise to the challenge to provide member benefits better than ever. Our Health and Wellness Committee has done an extraordinary job with our Virtual Doctor’s Lounges and the COVID-19 Resource Center. The Task Force on Convention Innovation has thoroughly evaluated the

educational needs and desires of our members and is prepared to take our CME events, whether online or in-person, to the next level. We provided outstanding virtual CME and OMT training through the newly designed Intensive Osteopathic Update. Our advocacy efforts have significantly increased throughout this year, especially pertaining to COVID-related legislation, support for osteopathic family physicians, our focus on vulnerable populations, the protection of the educational process for our medical students and residents, and championing a streamlined osteopathic board certification process. We have redesigned our committee structure and are taking a deep dive look at ACOFP’s governance structure so that we can be more inclusive, nimble and efficient with our limited resources.

Osteopathically yours,

Nicole Heath Bixler, DO, MBA, FACOFP

I am proud to say that the initiatives I had hoped to share with the 2,000+ registered attendees in NOLA have not been delayed. I am grateful for the support, dedication and collective energy of the ACOFP Board and staff in adapting to our new circumstances. I am looking forward to continuing these efforts and hoping that one day soon we get the chance to share an osteopathic hug. I am hopeful that our country can forge a path that includes empathy, peace and good health. In the meantime, I will enjoy some more late-night chats with my nine-year-old, sharing her hopes and dreams for the future.