Clarissa Barnes, MD, MBA, FACP, ACPA-C
Chief Medical Officer, South Dakota Medicaid
Hospitalist, Avera McKennan Hospital and University Health Center
Clinical Professor, Internal Medicine Department, University of South Dakota
President, American College of Physician Advisors
1. What is your current professional position?
Chief Medical Officer, South Dakota Medicaid; Hospitalist; Clinical Professor, Internal Medicine Department, University of South Dakota; and President, American College of Physician Advisors
2. Why did you choose internal medicine?
While all my classmates were finding their places with procedures or organ systems, I found myself falling in love with the way internal medicine physicians become experts in the care of individual patients. As internal medicine physicians, we take care of people with multiple chronic conditions and there are often not guidelines. (Or there are conflicting guidelines!) We are charged with taking multiple complexities and partnering with patients to help them make the best choices for their health and wellness. I chose internal medicine because even on the worst days, I am still grateful for the rare privilege to improve the lives of those around me.
3. What trends are you seeing in your day-to-day practice (with patients, the health care system, or otherwise)?
While the interests of patients and physicians are actually aligned at the most fundamental level (in my opinion), the system is not currently set up well to get results that make either group happy, which is leading to dissatisfaction (and, sometimes, misplaced blame). Additionally, the health care system is being increasingly asked to serve social safety-net functions without the corresponding resources to do so. There is an increasing need for physicians to be involved at the intersection of clinical and administrative/business functions in medicine and thus an increasing need for physician advisors.
4. What do you want to accomplish professionally within the next five years?
Personally, I hope to grow my leadership skills as I pursue my goal of improving the practice of medicine for both patients and physicians. I would like to publish the prior authorization process improvement work that was the basis of my MBA thesis in the hopes that it could help others decrease administrative burdens. Ideally, I would have written and published my first book.Â
5. Can you share a brief (and anonymous) patient encounter or professional situation that made you proud to be an internal medicine physician?
There was a patient with heart failure admitted with worsening renal failure. Nephrology offered dialysis, but the patient declined, in favor of going home. As I sat with the patient and their spouse and discussed the options, the patient was clear about their wishes and the spouse was set to honor them, but the spouse was clearly struggling. So, we shifted focus for a while and talked about their life together such as how they met and how many children they had had. Eventually, we came back to what they might expect after the patient went home and what resources might be available should they want them. Sitting with people on their hardest days and helping them make the decisions that are right for them while also providing advice and emotional support is a gift. You carry the stories of the people you meet with you and hope they continue to make you a better physician.