Healthcare Leader: Steve Sevigny, MD
By PL JETER
Steve Sevigny, MD, was born in Providence, RI, but moved to Sarasota when he was nine. The family owned a small business called The Trophy Shoppe and grew it into a landmark firm.
He attended the University of Florida as an undergraduate and medical student where he met his wife, Gina, also a med student. After graduation from medical school in 1994, they began residencies during which they both became chief residents, and then moved to Ormond Beach.
Sevigny, is a radiologist with Radiology Associates Imaging group headquartered in Daytona Beach, with practices at Halifax Hospital and imaging centers from St Augustine to Deltona. His wife is owner of Ormond Beach Dermatology.
He is a MSK fellow and has been in practice for 19 years. Sevigny serves on the board of directors of National Bank of Commerce (NCOM), Volusia/Flagler Easter Seals, and many other community organizations. He is running for U.S. Congress, District 6, which encompasses all of Volusia, Flagler, and parts of Lake and Saint Johns Counties. It is an open seat.
OMN: What experiences from your own practice do you want to see in national policy?
Dr. Sevigny: In radiology, there have been some recent policies that have clearly benefited patients. Most have been from programs started with the American College of Radiology and then continued to become national policy. In our practice, we begin reporting radiation doses prior to it being required. We used the national dose registry early on and continue to closely monitor our patient doses. That was a quality improvement program started by a specialty society that became law once the society could prove its usefulness. I prefer the medical societies driving the practice improvement aspect of regulations. Having underpaid junior staffers and interns on Capitol Hill with zero practical experience writing the rules is clearly suboptimal. We need people involved in the development of healthcare policy that understand how to get the best outcomes for patients.
Part of running for office is calling every physician you know to ask for financial support, in addition to moral support. It is amazing to me how many physicians I speak to that are fed up with the pace of work and the paperwork that has taken over their days. Too many of my med school classmates are not even practicing medicine any more. We must do better.
OMN: You've stated your support for a universal healthcare system. How do you see that system working...several elements to arrive at the goal or a single payer system?
SEVIGNY: We are the greatest, richest country in the world. We spend up to twice as much as every other country, yet we are the only advanced economy of the top 40+ that doesn't cover everyone. That HAS to change. There are plenty of options including a recently announced Medicare E option. I'm not tied to any one plan, but my overarching goal is for universal healthcare. It needs to go beyond universal coverage. A middle-class family with a $12,000 deductible does not really have the healthcare security that they deserve.
OMN: What are your thoughts on increased price transparency (and how we should get there)?
SEVIGNY: Price transparency is a significant issue, more so with the hospitals and pharmacies. There have been some recent attempts in working with pharmacists and pharmacy benefit managers to develop more consumer-friendly legislation. When a customer enters the pharmacy, the pharmacist should have a duty to research what is the best price for the customer. The PBM's have way too much power including, at times in some states, putting a gag order on pharmacists. It's no secret that Big Pharma spends hundreds of millions of dollars lobbying every cycle. We need a new generation of leaders that will put people before the entrenched paradigm of money and power. Consumers (patients) shouldn't be wrought with fear every time they enter a doctor's office or a pharmacy, or so fearful that they don't even seek the treatment or medicine they need.
OMN: What are your thoughts on the trend of healthcare consolidation?
SEVIGNY: I believe the governmental regulations have played a significant part in that. I can't remember the last independent, new physician practice that has started in our area. As an independent radiologist, it is concerning to see every physician employed by the major hospital systems. Our Radiology practice has been successful through the years because we have always felt that we needed to be the best we could be, better scanners, fellowship trained radiologists, specialty reads, beautiful centers, and exceptional employees. True competition means better care for our shared patients.
OMN: What about site neutral payments? What is your view of the optimal way to reimburse the different types of providers?
SEVIGNY: Giving hospitals more favorable reimbursement over physician-owned facilities only hurts the patient. The power pendulum between hospitals and physicians has become completely one-sided. Physicians have allowed the hospitals to dictate key healthcare policy by our political inactivity. As President of the Volusia County Medical Society this year, I have reached out to so many hospital-employed physicians in the hopes to get them back involved. We have increased our membership with great programs, but still there are too many physicians who just punch the clock and have given up. The county medical societies have all felt the decreasing memberships.
OMN: Do you favor revoking the tax-exempt status on nonprofit hospitals that abuse it, and at what point do you consider abuse taking place?
SEVIGNY: The Affordable Care Act has made the majority of hospitals more profitable than they ever imagined. The implied deal was that then they would open up community health centers and step up their primary care efforts to work on getting healthcare costs down across the system. Unfortunately, that did not happen. In fact, numerous hospitals have decreased their indigent care efforts. Since Florida rejected Medicaid Expansion, those factors have been blunted in our state. The "non-profit" hospitals have used this windfall to build more physical facilities and hire more administrators to comply with increasing regulations. Politics aside, the state's healthcare has significantly suffered due to the lack of Medicaid Expansion.
OMN: What roadblocks do you see, from the large hospital systems, for the changes in policy you'd like for the country
SEVIGNY: Physicians need to support/elect more physicians to office to fight for the independent practice of medicine. Political parties aside, a physician will understand the issues better and will represent physicians better. We need more people inside the political system that understand patient care and the realities of being a doctor.
For decades, PHARMA and others have used the political system, mastered it even, to drive their profits upwards with little regard for the patients or doctors in the healthcare system. To reverse that trend, we need to learn to use the political system just as well. We have numbers on our side, everyone needs healthcare.
OMN: What are your thoughts on MACRA and the future of the independent practice of medicine
SEVIGNY: One of the primary reasons that I am running is the current level of stifling regulation and the reimbursement threats that are coming from the MACRA/MIPS implementation. I understand the concept of quality versus quantity, but the current methods are useless. In Radiology, the quality measures are more based on the vocabulary used in reports with no regard for the true quality of practice. I have heard from many clinicians how much more time they have to spend on the administrative side of patient care rather than the actual care of patients. The threat to reimbursements in two years based of your performance this year without any current feedback mechanism is causing anxiety across the country with physicians.