The FAFP Family Physician Executive award was created to recognize an outstanding family physician for his or her role as a physician executive. This award is reserved for Florida Academy members whose executive skills in health care organizations have contributed to excellence in the provision of high quality health care, and demonstrated that family physicians can have an impact on improving the overall health of the nation. This award is to recognize exceptional leadership by a full-time family physician executive and will not necessarily be presented each year.

Eligibility Requirements: Nominees for the 2020 Family Physician Executive Award must meet the following requirements:
  • Documented executive leadership skills in health care organizations through:
    • Encouraging innovation in health care financing, organization and/or delivery.
    • Contributing to excellence in the provision of high quality health care.
    • Improving patient safety and well-being.
    • Fostering the tenets of family medicine.
  • Have a minimum of five years experience in an executive leadership position.
  • Be a current member of the AAFP/FAFP.
Note: Typical health care organizations include, but are not limited to, integrated delivery systems, local, state and federal government agencies, commercial health insurance companies, quality improvement entities and large medical groups. It is not the intent of this award to recognize leaders in academia though candidates whose professional duties include limited clinical or academic responsibilities are eligible.

All nominations must include the following information to be eligible for consideration:
  • A completed nomination form via this application
  • Current Curriculum Vitae (attached below)
  • A minimum of three and a maximum of five letters of recommendation (attached below). At least two of the letters of recommendation must be from employees of an organization in which the nominee held an executive position.
  • Color 5x7 professional photo (with high quality resolution)
The application and supporting documents (as noted above) must be sent together in this application and received at FAFP no later than June 30, 2020.  Questions, please contact Jennifer Young at jyoung@fafp.org or (904) 726-0944.

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* 1. Name of individual completing application (include email address):

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* 2. Physician Nominee Name:

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* 3. Physician AAFP/FAFP Member ID:

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* 4. Physician Home Address (include address, city, state and zip code):

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* 5. Physician Home Phone Number:

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* 6. Physician Office Address (include address, city, state and zip code):

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* 7. Physician Office Phone Number:

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* 8. Physician Email address:

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* 9. Please upload a copy of the physician's CV for review (limited to 3 pages):

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* 10. Physician's Personal Statement (if applicable):

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* 11. Please upload copies of supporting documentation (letters of support up to 5 pages)

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* 12. Please upload physician professional photograph (color 5x7 photograph)

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