Focus on Physician Leadership: Get to Know Eric Silverman, MD
December 6, 2018
You were appointed to the NEQCA Board of Trustees in 2015. Why were you interested in joining the Board?
NEQCA has a superb Board of Trustees and executive leadership team. Leadership clearly values physician input and is very effective at consensus building. I enjoy interacting with board members at social events and find them very approachable and genuine. I knew it would be a learning experience and a chance for me to grow. I also wanted a seat at the table to better understand the key issues and represent our unique organization.
As a specialist leader, what role do you see specialists playing in the evolution of value-based medicine?
Our Local Care Organization, MetroWest Healthcare Alliance includes 42 primary care physicians and more than 175 specialists. This skewed ratio presents some significant challenges, as many specialists are still living in the fee-for-service world and have not yet made the essential transition to value-based care. This is bad for our LCO and the NEQCA network because it increases our total medical expense and erodes clinical integration. Having said that, I fully understand that we need specialists to be successful, and I think the key is getting the right number of high-quality individuals and engaging them in a fair and strategic way. For 2019, we are we are thinking about citizenship requirements, such as meeting attendance, nighttime and weekend call coverage, tertiary retention, and participation in the Wellforce Care Plan (Medicaid ACO) as requirements that can help us drive improved specialist engagement.
In a time where there's an aging primary care physician population, how are you able to attract younger PCPS? What is the role of the LCO in this succession planning?
Loss of our primary care base is our major existential threat. While we offer a higher degree of autonomy than other physician organizations, we also need to perform well to be successful, so we need to strike the right balance on autonomy. Some PCPs have left competing groups to join our Alliance because they want more flexibly in the design and management of their practice. This is a good source of new PCPs but it isn’t enough and we are looking to Wellforce to help us design a business model that enables successful PCP recruitment and succession planning.
Given your location in a competitive geography how do you manage competing constituents?
It’s not easy. Our LCO is challenged by many competing forces and factors, including multiple community hospitals and physician organizations in our market. We recognize that patients are going to use these hospitals and ancillary centers, and we need to keep beating the drum of working together to provide the highest quality of care to our patients at a lower cost. Being part of NEQCA offers us a unique opportunity to stay true to this message. Within Alliance, we have multiple business entities competing for market share. We try to stay out of these turf battles as long as the playing field is level. We advise our physicians to look for value among colleagues, and other professional and ancillary services, when making referrals. Finally, the MetroWest area has three strong physician organizations: Alliance, affiliated with NEQCA; Charles River Medical Associates, affiliated with Partners; and Southboro Medical Group, affiliated with Reliant/Optum. While we believe that most Alliance physicians would not be happy in these other organizations, they have been more effective at hiring new PCPs and taking over the practices of retiring physicians, hence our need to focus on recruitment and succession planning.
I understand that music is an important part of your life. How did this come about?
I’m not much of a musician, but to my great delight and pride, both my daughters are talented and successful musicians. Ariel fell in love with the French horn in sixth grade and was first chair in the National Youth Symphony Orchestra. She is now a member of the Harvard-Radcliff Orchestra, and has an interest in environmental law. Kayla is a singer-songwriter and plays the piano. She is a junior high school and wants to be a pop-singer-superstar. I am hopeful, but tactfully encourage a career in the music industry with an MBA or law degree. Recently, I expressed a little disappointment to my father that both daughters have no interest in medicine. He told me to stop complaining about the state of healthcare. This is good advice.
Do you have any other interests or hobbies outside of your work as a physician?
If you give me a tool belt, I know how to use it, and I like to build things. I enjoy woodworking, gardening, fishing and sailing. My last midlife crisis consisted of building a small fishing boat in our garage. It blocked the parking space for two years, but my wife relented because it’s cheaper than a sports car.
Above: Dr. Silverman hiking in Peru with his wife, Debby
Read other Focus on Physician Leadership interviews in this series:
Get to Know Kelli Kennedy, MD (September 2018)
Get to know Ted Herwig, MD (June 2018)
Get to Know Pratiksha Patel, MD (March 2018)
Get to Know Dan Driscoll, MD (November 2017)