Amber Lesley, MD, on Physician Engagement, MA, & “Administrivia”

In our “Physician Voices” podcast series, we welcome doctors to share their unique stories, expert perspectives, and helpful insights. This candid Q&A with Amber Lesley, MD, a Texas-based internist, shares tips to reduce administrative burden, cultivate physician engagement, succeed in Medicare Advantage and value-based care, and more.

This excerpt of our conversation has been edited for length and clarity. You can listen to the full episode below and find us on Apple Podcasts, Stitcher, or your preferred podcast platform.

Given the massive changes happening and still to come in healthcare, it’s vital that we foster a culture of physician engagement to help navigate the growing pains. How important is culture to you as a doctor? And how can empowering physician leaders build a culture that prioritizes collaboration without sacrificing autonomy?

First of all, culture is extremely important to me. That means being able to lead by example. That means creating a culture that rewards the behaviors that we want to see within our staff and our patients, in terms of medication adherence, working on their lifestyle changes, and such. Culture is huge when it comes to fostering those meaningful changes.

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Within the physician group, autonomy is important to the physician-patient relationship. You have to maintain proximity to that relationship. The further removed you are from that exam room — where the conversations and decision-making happen — the harder it is to impact the care of that patient. That’s why I think clinical autonomy is so valuable. Doctors often know what the patient needs, even if we don’t have the resources to get it to them. Take prescription drugs, for example, especially the ones that aren’t generic and the cost related to that, or cases where the patient’s issue isn’t medical so much as social or financial.

As physicians, the more autonomy we have to make those changes and decisions within our own practice that can directly impact that patient at the point of care, the more satisfied we’re going to be. We’re going to feel like we have more control. We’re going to be able to share that and to improve the care of our patients much more effectively.

Autonomy is important, but I think you also need to have physician leadership. Because without that, you’re further removed from the relationship in the exam room, and you’re less able to impact the care of the patients you serve.

For example, the beginning of COVID-19 really demonstrated the value of physician autonomy, leadership, and partnering with a group that has flexibility. Here in North Texas, we had just launched a lab and pivoted pretty quickly after the beginning of the pandemic to provide drive-through COVID testing.

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That was a game changer for our patients. If we hadn’t had the structure that we did, we wouldn’t have been able to provide that. I really think that helped me keep my doors open, which preserved our revenue flow and allowed me to continue to care for my patients. We didn’t miss a beat when it came to mammogram screenings, colonoscopies, or getting patients the surgeries they needed because we were able to get them tested and get their results quickly. That’s the power of a group like ours; thanks to the physician leadership, we could pivot quickly and provide what was needed for our offices and our patients.

Your response perfectly illustrates the power of partnerships to drive physician engagement, autonomy, and collaboration. How can a partner help private practices grow and flourish?

One of the most important tools to help me do my job as a physician in private practice is pooling resources to offload administrative tasks. Especially the more tedious tasks, reporting being a big one. We have a large Medicare Advantage population, so those reports are valuable. But what happens a lot of times, no matter how well you try to program a computer to spit out a report with meaningful data, there are usually problems.

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I think a lot of what contributes to burnout among physicians is the amount of “administrivia.” That’s not why — or what we signed up for when — we went into medicine. However, we can solve for that with groups like Privia. They can vet and clean up reports then get that information into the hands of physicians when and where it’s actionable. They can take a report with 50 patients on it, half of whom are inaccurate, and wean it down to the 20 who really need the action. That’s meaningful, impactful, and provides value to physicians. It’s a work in progress. It’s not perfect. We’ll always be refining the data side. But you also have to recognize that you can never eliminate the human component that goes into making these reports what they need to be in order to be useful.

Amber Lesley, MD, is an internist at Texas Health Care in Fort Worth and member of Privia Medical Group — North Texas, where she serves as the Assistant Medical Director for Value-Based Programs as well as the Quality Medical Director for the Medicare Advantage program, roles she has held since 2014. Outside of these roles and her practice, Dr. Lesley enjoys traveling, gardening, spending time with family and friends, and Broadway musicals.