Guido Macchiavello, SBH Health System

Dr. Guido Macchiavello is an internist and Site Director of Ambulatory Care at SBH Health System. Dr. Macchiavello is also on SBH’s DSRIP Site-Specific Implementation Team, working with his team to pilot the launch of DSRIP projects. SBH plays a crucial role in BPHC’s projects and governance, and is BPHC’s lead applicant.

“We’re always adapting the way we practice,” says Dr. Guido Macchiavello, an internist and Site Director of Ambulatory Care at SBH Health System. “And not just because we want to. No, it’s because adaptation will benefit our patients.”

Adaptation, Dr. Macchiavello says, starts with being curious about the lives of his patients. “Our scope is their entire environment,” Dr. Macchiavello explains. “I know their religions, how many kids they have, how many partners they have, what their home environments are like. You have to be curious to learn how to help them.”

This curious mindset has made it easier for Dr. Macchiavello to adjust to the changes underway at SBH. After achieving recognition as a Patient Centered Medical Home in 2013, SBH is now leading the transition to DSRIP. “The key word is always growth,” Dr. Macchiavello says. “When I started here in 2010, I was just a newbie trying to adjust to the system that was already running. But when you become more and more part of a team, you start bringing up ideas about how to work better, to grow.”

To Dr. Macc, DSRIP feels different than past performance improvement initiatives that he has been involved in. “DSRIP is raising the bar,” he says. “Now we’re approaching society from every direction to make an impact on health.”

Although BPHC’s projects are in the early stages of implementation, Dr. Macchiavello and his team are already starting to modify the way they practice. “We’re focusing more now on smoking cessation, we’re focusing more on prevention, obesity, and mental health as part of DSRIP,” he says. “We’re adding more resources. I think learning to work with those resources will be the next challenge.”

These changes are not always easy. “You get used to practicing in a way that makes you comfortable,” Dr. Macchiavello says. “And believe me, to break that level of comfort takes a lot from you.”

“But think of it this way,” he continues. “The first time you run a marathon, you’re scared, you don’t know if you’re going to finish…and then you finish! You know you can do it. I know we can do it.”

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(Published April 20, 2016)