AMGA Conference Recap: How Execs are Tackling Challenges and Opportunities

A pair of chief physician executives talk trends with HealthLeaders at the recent AMGA Annual Conference.

The AMGA Annual Conference that concluded last week showed medical groups and health systems are rising to challenges and seizing opportunities, says John Kennedy, MD, AMGA chief medical officer and president of the AMGA Foundation.

Medical groups and health systems are facing a range of challenges, including workforce shortages, improving patient access, addressing health disparities, and adopting artificial intelligence solutions. All of these issues were front of mind during the AMGA Annual Conference.

Kennedy told HealthLeaders that he was impressed by the embrace of innovation shown at the annual conference.

"Medical groups are addressing key challenges such as physician engagement and physician resilience," he said. "I spend a lot of time with chief medical officers, and they have their workforces front-and-center. They are investing in new technology to help offload work from physicians. Chief medical officers are working to allow their physicians to spend more face-to-face time with their patients and less time in the electronic health record."

To address workforce shortages, medical groups and health systems are striving to improve the efficiency of clinicians and other healthcare workers, Kennedy said.

"There is a recognition that you cannot just continuously throw more people at the problem," he said. "Medical groups have physicians, advanced practice providers, case managers, pharmacists, dieticians, and other healthcare workers. There just are not enough healthcare workers to fill the entire need for staffing."

Kennedy said technology is at the heart of efficiency-gaining efforts at medical groups and health systems, and he gave two examples.

First, medical groups and health systems are adopting ambient transcription services in clinics to reduce clinician administrative burden and improve patient experience.

"The doctor can use their smartphone to capture all the elements of a clinic visit and immediately produce a medical note that requires only a short review for the physician," he said. "Ambient transcription services allow the clinician to engage the patient without working on a computer at the same time. The doctor is happier, and the patient has had a better experience."

Second, medical groups and health systems are adopting solutions to reduce the burden of in-box messages. "Doctors get all sorts of messages in their in-basket," Kennedy said. "It can come from a patient portal. It can come from phone messages. It can come from lab results or imaging. Those messages have gone up about 29% year-over-year since the coronavirus pandemic."

In-box solutions include artificial intelligence bots to help triage messages to the appropriate level of care and telehealth physicians who can provide remote care, he said. "What you are seeing is that messages are getting answered faster. Patients are more satisfied. And the huge volume of in-basket messages is starting to get under control."

Health equity is both a challenge and an opportunity, Kennedy said.

"The medical groups are all enabling their data systems to collect health equity data that is being required in accountable care programs," he said. "They must report on demographic information, race, gender, ethnicity, and insurance status. Medical groups' data systems are being set up to collect this data, and they are identifying underserved communities and developing programs to address underserved communities."

There are two primary areas related to patient access challenges, Kennedy said.

"One area is related to workforce. Medical groups need to strive to have fully staffed clinics—not just physicians but also nurses and the support staff. Medical groups are catching up on staffing after some difficult years during the coronavirus pandemic," he said. "Another area is related to technology. What we are finding is that patients are now able to self-schedule appointments from home. So, there can be openings in a doctor's schedule that have occurred in the previous 24 hours. Patients can fill those openings themselves, which improves access because there are fewer open visits in a doctor's schedule. In this way, clinics are getting more patients in sooner."

Chief physician executive perspectives

A pair of chief physician executives shared their views in separate interviews with HealthLeaders at the AMGA Annual Conference.

There are three keys to success in relationships between health systems and physician groups, said Bedri Yusuf, MD, MBA, chief physician executive of Northeast Georgia Physicians Group.

"The No. 1 key to success is trust," he said. "The second key to success is identifying the major challenges for the health system, then the medical group needs to consistently deliver on addressing those challenges. Third, physicians must buy-in to the health system's goals and what the health system is trying to achieve such as value-based care. When physicians are committed, you have accountability."

It can be a challenge to maximize the value of the interaction between a health system and a physician group, Yusuf said.

"There is a perception that medical groups lose money. But if you establish that a medical group is an investment in healthcare and the community, there are downstream benefits such as care efficiency, clinical outcomes, and meeting your mission," he said. "In our health system, we have pillars including safety, quality, healthcare stewardship, and healthcare delivery. If our medical group addresses those pillars point-by-point, we can generate revenue, achieve cost avoidance, make referrals to the hospitals, and attain improvements in service. By bringing new patients to the hospitals, we are adding to the bottomline and advancing the health system."

Matthew Mulder, MD, executive vice president and chief physician executive of UW Medicine's Valley Medical Center in Seattle, shared the keys to success for chief physician executives.

"First off, you must build your clinical credibility prior to taking the role," he said. "You also need to have a good relationship with the clinicians that you work with—you need to be a good listener and truly understand the needs of your clinicians. Likewise, you need to understand the needs of the administrative leaders you work with, who may not necessarily have a clinical background."

A chief physician executive must be intentional in bridging any gaps with administrative leaders, Mulder said. "Having common goals and common objectives helps," he said. "You need to understand their challenges, and they need to understand your challenges—very often, they are similar."