Leadership Profile: Margaret A. E. Jarvis, MD, FASAM

Have you ever tried to bring a group of people together to work on a project? If you have, you know that it requires special gifts: the gifts of consensus-building and leadership. This challenge is especially great when the project in question is a scientific or medical document such as the new . Margaret Jarvis, MD, FASAM, who is the Chair of the Quality Improvement Council, which oversaw the development of the guideline, possesses these qualities in spades.

Dr. Jarvis became involved in ASAM through the influence of Dr. Sid Schnoll, who was her mentor and was active in ASAM for a very long time and introduced her to the Society. As she says, “I really felt right at home with the people I met and the compassion they have for the addiction patients we all treat.” She loves being involved with ASAM because she has many close friends and colleagues and being active “is a way to be with them” and loves being a leader in ASAM because she “see[s] the potential for significant change in the field.”

The guideline was developed for several reasons. Dr. Jarvis cites the opioid epidemic, the variety of medical treatments, and the variation in care as the driving forces behind its development. She says that “there is such variation in care that it is difficult for those of us who are specialists to know what constitutes good care, much less patients, families, health systems and payers.” The National Practice Guideline was developed with support from Treatment Research Institute (TRI), using the RAND/UCLA Appropriateness Method (RAM), which combines scientific evidence with clinical knowledge to develop recommendations. The accumulation of evidence through clinical trials significantly lags behind practice for the treatment of addiction involving opioid use. The RAND/RAM allowed ASAM to develop a valid set of recommendations using this recognized methodology.

When she looks at what the future holds for ASAM and the Quality Improvement Council, Dr. Jarvis is looking forward to looking at applying the guideline and the maintenance of the performance measures which were released in 2014. She also sees ASAM taking a larger and more influential role in medicine in general, not just addiction medicine because “there are not enough physicians to care for patients facing addiction…[so] the addiction physician workforce needs to be filled with people who are good leaders. We need to be able to lead teams who provide the care, multiplying the effectiveness of the individual physician.” She feels that more emphasis needs to be placed on developing leadership skills so that physicians who work with patients who have a sub stance use disorder can take a role in leading treatment. If you are new to the field of addiction medicine, Dr. Jarvis says that even if you are not a “super-specialized academician or a well-funded researcher” you can still make a great impact in your area.