South Florida Hospital News
Friday August 23, 2019

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December 2007 - Volume 4 - Issue 6




Dr. Spier Prepared to Deliver Solid Leadership to BCMA

As a physician specializing in obstetrics/gynecology, Nigel A. Spier, M.D., FACOG, has delivered well over 2,500 babies into the world. Now, in an extended non-clinical role as president of the Broward County Medical Association, he’s eager to assist in the "birth of some exciting new programs" for the BCMA.

Photography by Joey G. Photography
In doing that, Spier is emphasizing a basic factor affecting the nation’s health system – economics – as well as increased advocacy by physicians in matters that impact them.

"That (economics) may come as a surprise to many, since it’s not a hot button, catchy issue like Medicare reform, the uninsured, tort reform or expanding coverage for children," Spier, who has been a member and leader of numerous professional organizations throughout his career, said. "But they are all related to the same principle. To borrow a slogan from another era, ‘It’s the economy, stupid!’"

Spier, a native of London with a private practice in Hollywood, said the bottom line is that "everyone is trying to get a bigger piece of a shrinking pie."

"Healthcare now accounts for 17% of our GDP (Gross Domestic Product)," Spier said. "That would be okay if it meant it was contributing to the growth of our economy. But it¹s not. In fact, resources are being drained away from our economy, and from our healthcare system, because everyone is looking to get in on the action, as it were, without putting anything back into the system."

This, Spier continued, means "trial lawyers, insurance companies, pharmaceutical and other business interest CEO¹s, and even politicians, have approached healthcare as an area where maintaining the status quo is good for business."

"If we can change that attitude, and direct our efforts to create a system that is efficient, effective and self-sustaining, everyone benefits, and we can focus our attention on other issues," he said. " If we don¹t, we will continue to struggle to meet a growing demand for services with ever diminishing resources."

While healthcare becomes a key issue during presidential election campaigns and then seems to move to the back burner when the voting is over, Spier sees a different situation this year.

"There is a palpable sense of urgency, precisely because so much of our economy is affected by the healthcare dollar and where it is spent, and it is limiting our ability to compete on the world stage," he said. "I think there is more than a sense of simply doing ‘the right thing’ for the sake of scoring political points this time around. It¹s a matter of economic survival."

In creating a more efficient and effective healthcare system with its own self-sustaining economy, Spier said one of the best ways to achieve that goal is to modernize the process with greater use of information technology.

"Every other service industry has benefited tremendously from the efficiencies afforded by the use of information technology since the 90¹s," he said. "Some claim that healthcare is different because of the sensitive nature of the information. I would argue, however, that the banking industry deals with information that is perhaps no less sensitive and functions today almost entirely on electronic transactions and data exchange. There is no reason healthcare can¹t do the same. The difference, again, is that the banking industry recognized the benefits of a collaborative effort and there was a universal push to change the environment. In healthcare, by contrast, we are still playing a game of monopoly. Everyone is looking around to see who will be the next Microsoft."

Some efforts like CCHIT (Certification Commission for Healthcare Information Technology (, are beginning to make an impact to change that culture and work toward universal standards, he said.

"But we still have a long way to go to make these technologies accessible and affordable to the average physician,". Spier said. "However, I believe this must and will happen in the next five years if physicians demand it. If there is a silver bullet that can fundamentally change the economics of healthcare this is it. This has to be our moon-shot."

Spier, who earned his Medical Degree at McGill University in Montreal, Canada and who is board certified by the American Board of Obstetrics and Gynecology, also reaffirmed his belief that it is "absolutely vital" that physicians be engaged in the political process and advocacy for medicine and healthcare.

"As is often said, ‘If you are not sitting at the table, chances are, you’re on the menu!,’" he said. "It is increasingly difficult for physicians views to be heard in Tallahassee or Washington D.C. when other special interests with far more money and power have an ever growing influence on policy decisions. Some of the common sense solutions we have been advocating for so long have been beaten down so many times that I fear some physicians have simply given up.

"But we can¹t afford to do that," he continued "We must remember that when we advocate for healthcare policy it is not simply for ourselves that we do this, but for our patients. (Patients) are our greatest ally and we must do a better job of educating the public, as well as our own community, on how healthcare policy affects them. But physicians can only do that when we band together, stand up and speak out for what is right for us and our patients. Membership in medical associations at the county, state and national level is critical if we are to have any voice at all."

For more information, contact Cynthia S. Peterson, Executive Vice President, Broward County Medical Association, at (954) 714-9477 or
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