Structure leads to success. It works in the Army—and for ACOs.

This column is part of a series of firsthand physician accounts that detail how AMA Health System Program members are moving medicine to support patient health and the medical profession.

Physician leadership is as important as it is undervalued. Research shows that physician-led accountable care organizations (ACOs) excel. However, to position these leaders for success, it’s vital to have the right support structures in place. The confidence of knowing we’re backed by those support structures inspires us to do our best, both as individuals and as a group. Together, we can advance care quality, efficiency and coordination, which are the pillars of value-based care.

As we approach the Veterans’ Day holiday when we rightly honor the service of the brave people who have kept our nation free, I’m prompted to think about my own time serving as an internal medicine PGY-1 at the Eisenhower Army Medical Center at Fort Gordon in Augusta, Georgia, and how it connects with the work I do now to help deliver outstanding care. 

In military jargon, a POD can be used to refer to: place of duty, point of departure, personnel on duty, plan of the day notes, and more. Folks in the military love their acronyms. At Privia Health, we have our own use for the acronym POD, which we use to refer to our “physician-organized delivery” groups. As a POD leader, I draw extensively from my past experiences in the armed forces. In both military and clinical governance, it’s essential that the leadership structures promote clear communication and morale.

If our ACO is the battalion, think of PODs as platoons: local, self-governing subsets aligned with the greater mission of improving patients’ lives and physicians’ well-being. This gives each POD the flexibility to respond to the unique demographics of our region and patient base. 

However, all physician-organized delivery groups share three key features: 

• Dyad. They include Privia’s diverse subject-matter experts who offer guidance and feedback.   
• Egalitarian. Doctors are equal members. While I lead my local POD, we’re united by an “all for one, one for all” mentality that prioritizes teamwork.
• Incentives. To promote engagement and collaboration, participation is directly linked to shared savings distribution.

That is how physician-organized delivery groups work. Now, here are three reasons why they work. 

In the armed forces, for orders to be followed, they must first be understood. This comprehension relies on clear communication, but our profession is often “multilingual” because the way we talk to patients in the exam room is very different from the legalese of payer contracts. 

To ensure clear communication in pursuit of that goal, PODs are designed with two principles in mind: 

• Objectivity. POD meetings are data driven. We trust each other to check egos at the door, analyze our metrics, and have the honest, constructive conversations needed to translate facts and figures into better patient care. 
• Collaborative, yet competitive. We’re united not only by our commitment to our patients but also by our drive to excel. Tapping into our individual competitive streaks and pushing ourselves to work at the top of our license while keeping high-quality, patient-centered care as our North Star improves the group’s results as a whole. 

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All great military leaders recognize that strategy is the greatest weapon. In PODs, the same principle applies and takes many forms, whether it’s our deep dives into metrics to incrementally improve coding, referrals, and patient satisfaction or—to my previous point—adjusting documentation so payers fully appreciate the quality of care we’re already delivering. 

Beyond those technical tips, it’s about bonding over stories and experiences. Recounting a day-to-day frustration or eureka moment can dovetail into productive conversations. To leverage the power of formal and informal collaboration, PODs are built to include: 

• Diverse expertise. Privia complements our understanding of patient care with experts in population health, practice operations, risk adjustment, and technology to share best practices. 
• Multispecialty presence. While most POD members are in primary care, specialists are crucial. Their perspectives offer a 360-degree view to help coordinate care, improve quality and contain costs, thus driving value-based care.

Morale can be the deciding factor between victory and defeat. The combination of hectic days and the glacial pace of the health care industry’s transformation can be dispiriting. That’s why it’s essential that PODs boost morale through: 

Camaraderie. Those of us in private practice can feel siloed and unable to effect change beyond our practice. Privia helps offset this feeling through their annual National Physician Advisory Council summit, which welcomes and gathers doctors from across the country. Every year, I encounter old friends, new faces and bold ideas to advance patient-centered, value-based, physician-led care. 

Personal growth. I’m grateful to have participated in Privia’s leadership development program last year. The course paired me with doctors from different markets and Privia experts to analyze and refine clinical workflows. It was an incredible learning experience that leveled up my leadership skills, which I then brought back to my POD to help run more collaborative and effective meetings. 

When you combine these three elements, you get the last vital facet of leadership: operational excellence. Transforming health care feels like a Herculean feat. That’s why it’s essential that we recognize wins along the way. For example, my POD improved annual wellness visit rates by 10% in just one year. 

That may seem like one simple metric, but it translates into more opportunities to deepen relationships and give patients the compassionate care they deserve. Celebrating those types of achievements—even though the crusade is far from over—empowers us to keep fighting for a better system for ourselves, our communities and our patients. 

Dr. Carter is an internist and vice president of Mount Vernon Internal Medicine—which is affiliated with Privia Health, an AMA Health System Program member—where she has been since 2008.