Richard Baron, MD President and CEO-elect The American Board of Internal Medicine, Philadelphia
ABIM has focused on credentialing and opening discussions about unnecessary care. How will you build on those and what future projects can you see yourself involved in through ABIM and the ABIM Foundation?
The Board focuses on offering a professionally endorsed and publicly trusted definition of "the good doctor." Increasingly in our society, good doctors think about unnecessary care, both because it creates waste and because it causes potential harm. We will need to think carefully at the Board about how to bring that dimension of good doctoring into our definition, which doctors train toward and aspire to in practice. We also need to ensure that all our assessments are rigorous and trusted – but at the same time we want them to be relevant to doctors and support them in their efforts to improve.
You have taken an active role in ABIM's Choosing Wisely campaign, which seeks to open discussions about unnecessary care. Have you found the topic of unnecessary care to be a touchy one, or do you think doctors, the healthcare industry and patients are in a place to tackle the issue without fear of being branded as potentially withholding care just by suggesting certain procedures or medications may be unnecessary in certain circumstances?
I have been proud of our profession and the leadership it has exercised in the area of unnecessary care. Choosing Wisely is a voluntary program involving colleagues throughout medicine helping patients and doctors thoughtfully consider specific examples of things that we all know are done more than they should be. The broad participation of the profession, consumer groups and delivery systems itself speaks to an openness to examine this issue. Choosing Wisely is not about withholding care – it is about making sure patients get the care they need and not care that could be harmful and wasteful.
You have an extensive background working on projects that push innovation and primary care. Of the various projects out there in the primary care realm, do any stand out to you as being particularly effective at curbing costs and coordinating care to the benefit of patients and the healthcare industry?
I am particularly proud of the Comprehensive Primary Care initiative, a program offered by the CMS Innovation Center in partnership with commercial and public payers across the country to provide support for a new, high-value model of primary care. The wide embrace of the program, by payers, physician organizations and consumer groups, is deeply encouraging. It is too early to look for the results everyone is hoping for, but the very engagement of clinicians and so many other stakeholders is strong evidence that the initiative strikes a resonant chord.
Your bio says you served three years in the National Health Services Corps in rural Tennessee. How much of an impact did that service make on you as a person, physician and leader in the healthcare community and do you think an experience of working in rural communities should be required of medical students?
My experience in the National Health Service Corps in rural Tennessee made a deep impression on me, personally and professionally. I came from New York City, with the Steig cartoon map New Yorker cover on my wall as a literal depiction of my understanding of the world, to rural Tennessee and learned that the country was a lot bigger than New York! And I experienced a new vision of doctoring that I had not seen in my training: the physician as member of his/her community. The accountability was to patients as neighbors, friends, not just to a standard of care. It really changed the way I thought about being a doctor, and it has stayed with me to this day.
– Interviewed by Stephanie Bouchard, Managing Editor