Physicians Changing the World – Dr. Stephen Smith

I must say, one of the coolest things working here at the Community Health Center is the fact that many of our providers are consistently recognized by many outside sources for the incredible work they partake in. Most recently, I published a blog discussing one of the many accomplishments that our very own, Dr. Velandy Manohar, was recognized for. His influential research coupled with his driving passion brought him a “Champion of Change” nomination sent from one of the most powerful figures in health care, our Secretary of Health and Human Services, Kathleen Sebelius (learn what Dr. Manohar did to receive this recognition by reading my “Champion of Change” blog, published on October 3^rd). Today, I will be speaking about a doctor whose work with the American Board of Internal Medicine (ABIM) Foundation could save an estimated $7 billion on resources in primary care alone, and whose work to promote patient engagement has led him to be selected for the 2013 “Family Physicians who are Changing the World” award by the Family Medicine Education Consortium.

Before serving here at the Community Health Center, Dr. Stephen Smith served as the associate dean of the Warren Alpert Medical School of Brown University for 25 years. At Brown, Dean Smith was internationally renowned for his work in medical education and was also the architect of the competency-based curriculum which has been replicated at many medical schools around the world. Dean Smith later retired in 2008 and currently holds a position of professor emeritus of family medicine at Brown University. At this point, while most people would collect their 401k, new golf set and emigrate down south where it’s warm, Dr. Smith continued utilizing his incredible gift of understanding and foreseeing medical practices as he applied for a grant from Daniel Wolfson and the ABIM foundation.

The American Board of Internal Medicine Foundation seeks to foster professionalism in medicine through its Physicians Charter. Striving to achieve these goals, the ABIM started the “Choosing Wisely” campaign which encouraged physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary. Much of the structure for this campaign is largely due to Dr. Smith’s work. “Well, Steve is a real hero in my book because he was the one that applied for a grant from us suggesting that the National Physician Alliance should [list overused tests] in internal medicine, in family medicine, and in pediatrics,” Daniel Wolfson, Executive Vice President and Chief Operating Officer of ABIM, explains. Additionally, Dr. Smith spearheaded an initiative called “the National Physicians Alliance Good Stewardship Project” which asked physicians in internal medicine, family medicine and pediatrics, to identify five medical tests that could greatly reduce overall cost. Today due to the clever thinking by Dr. Smith, over 50 medical specialty societies, representing over 500,000 physicians has joined the Choosing Wisely campaign and came up with their own “Top 5” lists. Some examples of overused practices include a CT or an MRI after fainting, EKG or stress test at an annual checkup, and antibiotics for acute sinusitis. Dr. Smith and the others at ABIM Foundation are not saying that one should never partake in ordering these common diagnostic tests at the specified time, but instead be aware that they are high in cost, sometimes involve added risks, and are not necessary all the time.

Dr. Smith’s participation within the group doesn’t stop there however, as he later successfully applied for a grant to produce tapes on how physicians can better connect with their patients, and provide the security of alternative treatments as the consumers become more and more engaged with their care. If you regularly read my blogs, you are aware that I am an advocate of patient engagement and stress the importance of it on every possible opportunity. His pro-active initiatives have saved lives. If you would like to get a better sense of what I am talking about, I urge you to take a few minutes out of your day and watch the following TED talk by e-Patient Dave, http://www.ted.com/talks/dave_debronkart_meet_e_patient_dave.html. The reason for that quick ramble was not only because I want consumers to become more involved with their treatments, but so you can better understand what Dr. Smith is striving to do here. What he is saying is that as consumers get more involved with their care, they might support one form of treatment while the doctor may feel it could be both cost effective and more efficient to do it another way. This information needs to be delivered providing security and comfort to the consumer that the alternative course of treatment is the way to go but that their thoughts will still be considered bearing ineffective treatment.

The Community Health Center is truly a special place. The work all of our providers do on both a micro and macro scale continues to make the medical industry and its treatment safer and more efficient. They continue to improve the quality of care while depleting the high overall costs the industry used to yield  They are supremely unique individuals and are deservedly recognized by the highest, most powerful players in the country. Therefore, I would like to conclude this blog thanking our entire group of providers for the incredible work they have done and will continue to do.