Dr. Singer is a MBA student at Haas School of Business and a board certified geriatrician and family physician.  Most recently, Dr. Singer was the Director of Ambulatory Informatics at Cooper University Health System in Camden, NJ, where she practiced medicine part time while managing the ambulatory arm of Cooper's $30M system-wide electronic health record implementation.  Dr. Singer has sat on the board of the New Jersey Academy of Family Physicians from 2006-2008, and will represent the Alameda-Contra Costa County Chapter at the 2010 CAFP Congress of Delegates.  She holds a BA, magna cum laude, in Political Science from Middlebury College, an MD from Robert Wood Johnson Medical School, and a CAQ in Geriatrics from Jefferson Medical College.

I am a member of AAFP and CAFP because: I feel that it is important to support our society.  Although we, as family physicians, are providing excellent, cost efficient health care for the entire family, we are often not fully visible as a vibrant group to the public or the government.  Through our participation in the AAFP and CAFP, we are demonstrating our numbers and ensuring our voice is heard.

I think the most helpful CAFP resource is: The information and resources available on CME, practice management, and legislative news that give me the ability to participate at the state and national levels.

I chose family medicine because: As a medical student, I loved OB and pediatrics and found internal medicine really interesting.  Dean Mehne, the dean at UMDNJ-Camden, my medical school, mentored me and encouraged me to visit rural family practice in Pennsylvania to experience full-spectrum of family medicine.  It was wonderful!  I realized that day that I would go into family medicine.  Also, the importance of continuity of care in medicine was obvious and resonated with me personally.

What do you love about practicing family medicine?  The patients.

How do you champion family medicine?  I champion family medicine by speaking about it frequently.  I find that many people don't realize how comprehensive and versatile our specialty is.  I also advertise that I am a family physician and offer services that distinguish our specialty that I think might be interesting to my patients.  For instance, if a new pediatric patient comes in with her mother, I let them know that I, as a family physician, also do obstetrics and gynecology.  If the mother were to become pregnant again, she is more likely to realize that her family physician can provide the full spectrum of care with ultimate continuity.

What is the biggest opportunity or challenge you see in the family medicine specialty in the next five years?  The biggest opportunity family medicine faces during the next five years is to rise strong in the face of our nation's health care crisis and to reframe the discussion around the most valuable aspects of health care and how compensation is tied to that care.  I strongly believe that given the resources, recognition, and compensation, family medicine is one of the main solutions to the cost and quality complexities we face today.  Family physicians, pediatricians, and outpatient internists need financial and technical help implementing the most cost effective and enabling EHRs to consistently and measurably provide the highest quality care.  We already value and are well trained in cost effective medicine.

What is the biggest challenge facing health care today?  Any thoughts on how it could be addressed?  I believe our biggest challenge is the incentive structure.  We are not encouraging our best and brightest to provide high quality, low cost, preventive care.  Until the incentives are aligned with our goals, we will have relatively poor outcomes and escalating costs.  I believe we could begin to address this challenge through some the steps below:

1. Adjust compensation to encourage high quality, low cost care.  All insurance should be required to reimburse for preventive visits, blood work, and primary care prevention counseling, including birth control, healthy lifestyles, and end of life care.  Primary care physician reimbursements should be increased.  In order to encourage appropriate non-interventional care, the RVU system should be reworked to bring medical disease management reimbursements at least to the level of procedural reimbursements.
2. Paperwork from third parties might be standardized to decrease the administrative burden and save the system money.
3. All claims rejections should be completely open and published regularly to the public in an HIPAA-compliant fashion.
4. As the stimulus money takes effect and the digital infrastructure is built, physicians and their medical associations should agree to specific, appropriate measures for demonstrating quality outcomes.
5. These measures should be phased in and within five years reimbursements should mirror physician performance.
6. The withheld money from underperforming physicians should go towards CMEs for these physicians and/or governmental public insurance pools.  Insurance companies should not retain extra profits from withheld physician payments.

How do you spend your free time?  With my family, cooking and baking, hiking and spending time with friends

How do you define balance?  Balance to me is spending the right amount of time on each activity that I prioritize in my life.  In my case, that means my family and my work.

What is your favorite ice cream flavor?  Cardamom-Rose from Ici in Elmwood!

What was the best lesson you learned in residency?  The importance of human relations in medicine.

If you weren't a family physician, what profession would you most like to try?  In addition to being a family physician, I would most like to be an entrepreneur.  I love the idea of creating something where there was nothing before, and the excitement of being the first to do, or significantly improve, something.