Roberto Darroca, MD (right), was sworn in as ISMA’s 171st president at the 2020 virtual annual convention, succeeding Lisa Hatcher, MD (left). A resident of Muncie, Dr. Darroca is an OB/GYN with the Community Physician Network and is affiliated with Community Hospital in Anderson.

In his presidential remarks, Dr. Darroca discussed the five pillars of ISMA’s strategic plan and noted his special interest in two: developing future physician leaders and voicing physicians’ perspective and expertise.

“We currently have almost 9,000 members out of the 15,000 physicians in Indiana,” he said. “We have a loud voice. Can you imagine the influence the ISMA would have amplifying the voices of 15,000 physicians? We would have a deafening presence.

“We need to identify those physicians in the state of Indiana who would be willing to provide leadership to those 15,000 voices. We need to find leaders who can be mentored by current leadership to carry on this task of representing all physicians.”

To illustrate how sharing physicians’ expertise can drive the future of medicine, Dr. Darroca cited ISMA’s role in creating and passing the Indiana Medical Malpractice Act.

“The only way that we as physicians can stand up to an army postured against us is to coalesce as a unified body,” he said. “As a unified group, we were able to amplify the voices of the many. In the end, we were able to defend our malpractice protection and ensure that we could practice medicine in the way that our patients deserve.”

Physician expertise is also critical to maintaining physician-led care teams, Dr. Darroca said. “In my annual report as president-elect, I took the stance that our education as physicians cannot be cheapened. Our dedication and sacrifice to our profession cannot be disregarded. When it comes to scope of practice, we must lead.”

A native of Richmond, Ind., Dr. Darroca graduated from Marquette University with a B.S. in biology and earned his medical degree from the Indiana University School of Medicine. He completed his family medicine residency at Ball Memorial Hospital in Muncie (now IU Health Ball Hospital) and his OB/GYN residency training at Wright State University in Dayton, Ohio. He is board certified in obstetrics and gynecology and has practiced in Muncie more than 20 years.

Before assuming the presidency of ISMA, Dr. Darroca served as president-elect and speaker of the House of Delegates. He also chaired the ISMA Opioid Prescribing Task Force and served as trustee and a member of the Commission on Legislation.

Read the full text of Dr. Darroca’s presidential remarks below.

Hi, I’m Bob Darroca, your ISMA president. I am a practicing OB/GYN who is employed by a large health care system. Your representatives to the 2019 convention elected me as your president-elect. It has been my privilege to serve you in the capacity of president-elect. Under the leadership of Lisa Hatcher, the ISMA has progressed.

I’m ready to assume the responsibility to move the ISMA forward.

I have been involved in organized medicine since I was a freshman in medical school. I was a member of the Indiana Academy of Family Physicians. I was mentored by great physicians: Debbie Allen, Al Haley, Richard Feldman, Ed Langston and Fred Ridge. I was also guided by the Indiana Academy of Family Physicians’ executive vice presidents who held my hand as a medical student: I will be forever grateful to Jackie Shilling, and Deeda Ferree.

Now, I hope to put into practice what I have learned as I represent the physicians of Indiana.

Involvement in the ISMA has been nothing short of fascinating. Working with like-minded physicians who want the best for Hoosiers has been a blessing. These physician leaders are selfless. We had a strategic planning session designed to plot a trajectory to position the ISMA in a good place to meet the future challenges of medical practice. After an hour and a half of getting past how we would want to care for patients, we finally came around to planning how we would take care of ourselves so that we could take care of the health of Hoosiers. We modernized our mission and vision during that weekend.

The mission is simple: “The Indiana State Medical Association exists to maximize the leadership and impact of physicians.”

The vision is clear: “Physicians together, driving the future of health care.”

The pillars that were constructed that weekend guide our organization: Develop Physicians. Raise ISMA’s value. Innovate health care. Voice perspective and expertise. Empower. All of the pillars form the “why” of ISMA’s existence. Of those pillars, I have a special interest developing future physician leaders and voicing our perspective and expertise.

Organized medicine runs contrary to our personalities as physicians. We like to do things independently. We assimilate data. We synthesize data. We come to our conclusions. It is interesting that even when we all do this independently, we come up with the same conclusions. This trait of ours is valuable in the care of our unique patients.

However, in my experience in organized medicine, the only way that we as physicians can stand up to an army postured against us is to coalesce as a unified body. An example of being unified was in our defense of our Medical Malpractice Act. As a unified group, we were able to amplify the voices of the many. In the end, we were able to defend our malpractice protection and ensure that we could practice medicine in the way that our patients deserve.

Many years ago, we gave up control of how we are paid. We thought that we could negotiate with insurance companies as individual physician practices. How did that work for us? That began the creation of physician groups, physician networks and, ultimately, health networks. The voice of the many was leveraged to obtain concessions from the insurance companies. As groups, we stood a better chance to negotiate fair payment for our services.

The ISMA provides that leverage throughout the state of Indiana. We currently have almost 9,000 members out of the 15,000 physicians in Indiana. We have a loud voice. Can you imagine the influence the ISMA would have amplifying the voices of 15,000 physicians? We would have a deafening presence.

We need to identify those physicians in the state of Indiana who would be willing to provide leadership to those 15,000 voices. We need to find leaders who can be mentored by current leadership to carry on this task of representing all physicians.

We have physician groups in Indiana that advocate for their physician members. It is the task of the ISMA to support these groups. In situations where there is great controversy, we will bring the various sides together to have a dialogue. In the end, we need to recognize differences but maintain the house of medicine.

I invite all physicians of Indiana to be a part of the ISMA. Be a partner in our efforts to make Indiana the best place to practice for all physicians. Your support in spirit is appreciated. But, your support in membership can add to our growing voice as we advocate for all physicians.

In my annual report as president-elect, I took the stance that our education as physicians cannot be cheapened. Our dedication and sacrifice to our profession cannot be disregarded.

When it comes to scope of practice, we must lead. We cannot be blinded by arguments based on outcome. Outcome-based arguments are faulty, because good outcomes can be achieved even when practices place someone at risk. A good example can be found in my specialty of obstetrics. A nonphysician practitioner in obstetrics may not manage a gestational diabetic optimally, and the outcome might be a 10-pound baby with a prolonged shoulder dystocia. The baby does well, the mother is no worse for wear, and this is recognized as a good outcome. But – could there have been a better outcome?

We cannot be blinded by the argument that a lack of access to health care makes it necessary to place less-qualified medical personnel in a position to provide care without supervision. We are working on increasing access to care. The silver lining with the COVID pandemic is that telehealth has progressed rapidly. We could not have predicted even a few years ago what we have accomplished in telehealth technology. Nearly all physicians use telehealth in providing ongoing health care to Hoosiers. Many physicians are employing video in their practices. For those people in rural areas, this technology is no less than miraculous.

We cannot be blinded by the argument that using lesser-trained personnel to provide health care will save health care dollars. Physicians on average are more efficient with health care dollars. We order labs appropriately. We prescribe medications as needed. When the proper incentives are in place, we tend not to churn the system. All Hoosiers deserve the same high-quality health care.

I pledge that I will stand firm in insisting that the health care provided to Hoosiers be physician-led.

As physicians, we minimize the value of what we do. We are physicians every day. It’s what we are. As physicians, we can anticipate a problem and solve or treat it quickly, due to our training. As physicians, we tend to undercharge because we can solve problems quickly and it doesn’t seem like it takes much effort. As physicians, we use protocols as guides. Each patient is unique, and their condition doesn’t always follow protocols. As physicians, we can synthesize information like no other health care professional and adjust what we do. As physicians, we have the privilege and the latitude to make these adjustments to protocols.

So – let’s come back to the pillars that guide the ISMA, which form the acronym DRIVE.

D: Develop Physicians.
R: Raise ISMA’s Value.
I: Innovate Health Care.
V: Voice Perspective and Expertise.
E: Empower.

These are the pillars that we build around to drive the future of health care in Indiana. I invite all of you to join me in this construction.

God bless all Hoosier physicians.

Thank you, and good day.