Dr. David Barbe is more than the hometown doctor. Barbe, a physician who has been practicing family medicine in Mountain Grove for nearly 30 years, also manages Mercy’s clinics in the Springfield area, is a long-standing board member of the Missouri State Medical Association, and in June, became board chairman-elect of the American Medical Association. Barbe has been involved in shaping the nation’s health care policies and practices since 2003, and during the next year, he’ll be preparing to lead the management of the organization that serves 350,000 U.S. physicians.
Hometown Doc “I grew up in Mountain Grove. I went to high school there and then went to the University of Missouri for undergraduate and medical school. I graduated from medical school in 1980. I went to Wichita, Kan., for my family medical residency, which was three years. I finished in 1983 and came directly back to Mountain Grove and established a solo practice. I grew the practice, added partners in the Mountain Grove office and established a second site in Houston, Mo. … In the fall of 1997, I sold my practice to St. John’s, which has become Mercy.”
Policy Matters “I recognized early in my career that more decisions were being influenced outside of the exam room, and if I wanted to have a say in how medical care was being delivered, I was going to have to move beyond my own practice. It so happened that another physician from Mountain Grove was our area’s physician on the MSMA board, and he wanted to step down. He approached me … and I said, ‘Sure.’ That was 1987, maybe. The MSMA has about 6,000 members, and there is an annual meeting where policy is developed, and the rest of the time the board handles the business of the organization. We have headquarters in Jefferson City, and we have two full-time lobbyists and monitor hundreds of bills each legislative session. … The state medical associations are separate groups. However, they all participate as a federation and send representatives to the AMA.”
AMA Ascent “In the late 90s, I attended my first [AMA] meeting as an alternate delegate. … I was elected to the Council on Medical Service in 2003 (and) served one and part of a second term. I was instrumental in developing policies that formed the basis of a great deal of the AMA’s current policies on health care reform. I chaired that council 2008–09, prior to my election to the board.”
Reform Pros and Cons “The AMA did support the (Patient Protection and Affordable Care Act) … because we desperately believe that people need access to health care. … The good thing is that when fully implemented, coverage would be extended to 90 percent to 95 percent of all Americans. It includes subsidies for low-income individuals to purchase insurance. It provides for individuals to purchase their own insurance without their employers through a health care exchange. Children can remain on their parents’ policies until age 26 [and there is no] denial of coverage due to health issues – which is already in place for pediatric patients and in 2014 would go into effect for adults. A couple of the problems, from the AMA perspective, were things that were never included in the bill at all, (such as) national professional liability, or tort reform, (and) the Medicare physician payment system. One of the most egregious pieces of the legislation as far as the AMA is concerned is the Independent Payment Advisory Board. That is a newly created board that will oversee total Medicare spending.”
Back Home “Last year, I was on the road about 70 days for the AMA. This year, it will be more than that. Next year, as board chair, I may be on the road 100 to 150 days. … I think it is a great opportunity for me as a Mercy leader to be engaged on both the state and national levels, so that I can get the pulse of health care delivery across the country, see the trends and understand what is driving the changes we are seeing and bring those back to southwest Missouri.”