Five Questions With: Dr. Steven Lampert

DR. STEVEN LAMPERT is president of Lifespan Physician Group Inc. / COURTESY LIFESPAN
DR. STEVEN LAMPERT is president of Lifespan Physician Group Inc. / COURTESY LIFESPAN

Dr. Steven Lampert is president of Lifespan Physician Group Inc., a nonprofit, physician-governed group practice, with more than 500 medical providers specializing in primary care, psychiatry and behavioral health, women’s medicine, obstetrics and gynecology, pediatrics, cardiology, dermatology, neurosurgery, ophthalmology and physical medicine. A cardiologist, he served Atrius Health in Newton, Mass., as senior vice president and regional medical director, responsible for the largest regional business unit of more than 1,000 employees.

Lampert, who received his medical degree from the University of Vermont in Burlington and his Master of Business Administration from Boston University Graduate School of Management, talked with Providence Business News about the benefits and challenges associated with being part of a physician group, generally, and his goals and objectives for LPG, specifically.

PBN: Are physician groups in Rhode Island different from those in the Boston area; what are the strengths and weaknesses of each?

LAMPERT: Both communities provide great care with dedicated providers who are passionate about the quality of care they provide. I think the main difference is that physician groups in Boston are more likely to be part of a larger health care system and better integrated. Rhode Island has many small group practices, which may have come together for contracting with either an insurer or Medicare, but are not integrated. I think this is changing and Lifespan is providing leadership by pulling together a number of primary care practices toward creating an accountable care organization, which will better integrate primary care in our community. Patients are the main beneficiaries of a large, integrated system.

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Health care systems that are not integrated struggle to hit the Institute for Healthcare Improvement triple aim of improving the patient experience of care (including quality and satisfaction), improving the health of populations and reducing the per capita cost of health care. I think those are the correct expectations for any health care organization.

PBN: What are the benefits and disadvantages for a physician to join a group?

LAMPERT: Physicians practice medicine because they enjoy the art of healing and the satisfaction of being in a profession that provides enormous personal rewards. However, health care in the United States has become an increasingly complicated business with many reporting requirements, arcane rules and regulations that change frequently, financial incentive programs that require heavy investments into electronic medical records and expectations for knowing costs and controlling them while providing demonstrable high-quality care. It is becoming a large lift for small practices to invest time, money and people into the ever-increasing demands of our health care system. A large group practice has the scale, scope and resources to better manage the business and financial risks of health care than do smaller practices. The trick is to accomplish this without sacrificing the art and professionalism of medicine.

PBN: More physician groups, some of which have been acquired by hospital systems, are being established here. How do such changes impact an independent physician’s ability to practice, negotiate with insurance companies and provide high-quality, effective and reasonably-priced health care to his or her patients?

LAMPERT: My sense of physicians in Rhode Island is that joining a larger group is the last option they entertain when contemplating how to secure the long-term success of their practice. Some of this reluctance is based on previous bad experiences; for others losing any autonomy is difficult because they assume 100 percent autonomy is essential to high-quality patient care. This was not my experience. I was a physician in a multi-site, multi-specialty group practice of about 600 doctors who cared for more than 600,000 patients – more than half the population in Rhode Island. We measured, documented and reported our quality results and, as a pioneer ACO group, we had the second-highest quality scores in the nation. Our cost of care in populations – ranging from Medicaid to Medicare – was among the lowest in Massachusetts. Our contracting staff negotiated contracts better than what I could have negotiated as a member of a moderate-sized cardiology practice. So, for me, the best way to provide high-quality, cost-effective care is through a large, organized, integrated group practice. Practices that are worried about the coming changes in health care financing and are interested in providing high-quality medical care for their patients within an integrated health care network should consider LPG. An integrated physician-led group practice coupled with the resources of the Lifespan Corp. will be, in my opinion, successful as health care becomes more focused on quality and cost.

PBN: You have said, “A primary focus of [LPG] will be to create and implement new programs and initiatives between Lifespan and our physicians that will deliver superior care to the communities we serve.” What is LPG not doing that it should have been doing to provide such superior care, and can you provide some examples of new programs and initiatives that you intend to establish?

LAMPERT: My vision for LPG is to develop systems of care that improve the health of our patients by better coordinating the care between our many providers and the patient’s primary care providers. In developing that system, we will be leveraging the many resources of Lifespan, such as the data provided by our electronic medical records, in a way that identifies and corrects any gaps in the care we provide.

PBN: What are your three highest priorities for the first 12 months in your new position and what challenges might impede or interrupt accomplishing those priorities?

LAMPERT: Meet as many physicians in LPG as possible and learn what their needs and expectations are; develop both an administrative leadership team and a clinical leadership group to help me develop a three-year strategy for LPG, based on what I learned from the physicians; improve the patient experience whenever patients interact with LPG practices; and reduce the cost of care by continuing to integrate systems and better manage clinical care. In my role, I have not faced challenges that are impeding the progress that we are making.

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