BY SANDRA JACOBS, VITAL SIGNS EDITOR
Barbara S. Spivak, MD, has been an internist for more than 35 years in Watertown, MA. As the President of the Mount Auburn Cambridge Independent Practice Association (MACIPA), she has been a strong advocate for population health management, quality improvement
programs, care management, pharmacy programs, and using data to inform strategies.
She is an active, long-term participant in Massachusetts Health Quality Partners (MHQP) and a committed member of the state’s Quality Measure Alignment Taskforce and the American Medical Association’s Integrated Physician Practice Council. She has been
actively involved with CMS technical panels evaluating metrics for cost and quality.
Before becoming president of the MMS, Dr. Spivak chaired its Committee on Quality of Medical Practice and has been an active participant in strategic planning and governance reform initiatives. She has been recognized by the MMS for her demonstrated compassion
and dedication to clinical care. As a practicing physician, Dr. Spivak continues to devote herself to caring for patients, giving them concierge medicine without any extra fees.
Shortly before her MMS presidential inauguration, Dr. Spivak shared her thoughts with Vital Signs on the practice of medicine today and what’s ahead for the MMS.
VS: How did you first get involved with MMS?
Dr. Spivak: When I started running MACIPA, it was primarily a financial organization that did contracts with health plans. I was particularly interested in the organization’s quality of care. How could we know if we delivered
good care, poor care, or average care? I used data from MHQP to look at that, and by 2000 I had become involved in MHQP. Through that, I learned about the MMS and realized I’d been missing an opportunity to be involved in an organization that
did a lot in the areas that I cared about. That background with MHQP prepared me to be involved in health care strategy and advocacy through MMS. It has been very important to me to be a voice for quality in health care.
VS: What are the most significant quality issues that face physicians and patients now?
Dr. Spivak: There are several levels to that. Physicians are measured in many ways regarding the quality of care they deliver. But a big challenge is that a lot of those metrics are not ideal. The MMS has put people on many
committees that are addressing how to measure quality to help influence that output. I’m on the state’s Quality Measure Alignment Taskforce to narrow down the number of metrics in physicians’ contracts and to make sure that they are the right
metrics — they must be fair and reasonable.
VS: What are the profession’s biggest challenges right now? And how can organized medicine address them?
Dr. Spivak: Health care is in crisis now. Physicians are struggling to keep their offices open and staffed with a trained workforce. The administrative burdens are pulling physicians away from patients and increasing dissatisfaction.
We will need payment reforms and changes to minimize nonclinical efforts, like prior authorization and diagnosis coding. I believe this will take years, but I do believe we can fix this. I have a perspective and a passion for change that will
allow us to provide the type of care we want our patients to have.
VS: What are the top priorities for the MMS in the year ahead?
Dr. Spivak: For the past few years, the Society has created a very structured strategic plan, which narrows our focus and our priorities in a very intentional way to direct resources and attention in those strategic areas.
My job is to work with staff and committee leaders on those areas of focus.
Payment reform is a key priority. Lack of diversity is another big problem, not just in our membership and staff but also regarding equity in the care that we deliver. Here, in one of the most liberal states in the country, we have stark racial differences
between Black and White people in care and outcomes for infant and maternal mortality rates. We need to fix that and other areas of inequity.
We’ve also seen an upsurge in violence in this country, and that, to me, is devastating. As a medical community, we need to deal with not just gun violence but all manner of violence and aggression that is affecting many people.
VS: As a front-line practitioner for many years, what still gives you joy?
Dr. Spivak: I have been very lucky to have spent 38 years in the same office building and at the same hospital. The continuity I provide to my patients and their families and the stability in the hospital as a practicing physician
with my colleagues is quite rewarding.
VS: What would you tell a medical student about how to find this satisfaction in being a physician?
Dr. Spivak: I would advise medical students to explore different specialty rotations during their student years and to choose a specialty that fits their personality and life goals. I would encourage someone not to be afraid
of change if their first choice or work environment turns out not to be fulfilling. As physicians, we have many options — more than most. Find what is right for you.
VS: How do you spend your spare time outside of medicine?
Dr. Spivak: Being with family and friends is so important to me. I love being a grandmother. I’m fortunate that even during COVID, I was able to see my grandchildren. That was an enormous pleasure.
My passion is hiking. I’m a four-season hiker. In the summer, fall, and spring, if it isn’t too muddy, I hike, and in the winter, I snowshoe. Most summer weekends, I hike in New Hampshire or Maine. On vacations, I’ve hiked in Hawaii, the West Coast, the
Midwest, and some places outside of the United States.
Outside of seeing patients and her many leadership roles in health care, incoming MMS President Barbara S. Spivak, MD, enjoys hiking year-round, primarily in northern New England. The 2018 photo above was taken by one of her daughters while they
hiked together in Nepal. Photo courtesy of Barbara Spivak
