Member Spotlight: Dr. Lee Fleisher on His CMO Role at CMS, His Near-Miss As a Transplant Surgeon, and the Perils of Publishing

By Emily Cowan posted Nov 11, 2020 04:48 PM

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This past summer, Dr. Lee Fleisher was tapped as Chief Medical Officer and Director of the Center for Clinical Standards and Quality (CCSQ) at CMS - responsible for the quality of care for 147 million Americans. In this Member Spotlight, he tells ASA Community what he'll be tackling during his tenure and offers a window on some of his past accomplishments, most notably with ASA's Brain Health Initiative.

Nominated by @Dell Burkey, MD, FACA: "Academic Chairman at Penn, editor of several books on anesthesiology, member and Chairman of various ASA committees, highly motivational teacher of residents and fellows...Dr. Fleisher develops future leaders in our field."

(Is there an ASA member you'd like to nominate for a Spotlight? Tell us here.)

This past summer you were tapped as Chief Medical Officer for CMS. That’s quite a job to tackle under any circumstances, but even more so during this pandemic. What’s your main area of focus in this new role? What do you consider your biggest challenges and opportunities?

My current role is the Chief Medical Officer and Director of the Center for Clinical Standards and Quality (CCSQ) at CMS. In this role, I am responsible for the quality of care for 147 million Americans. As the CMO, I work across the Agency to ensure that there is physician input into payment rules and programs. It is more about influence and providing input to the Administrator. As Director of CCSQ, I oversee the coverage, conditions of participation, survey and certification of hospitals and nursing homes, quality improvement organizations (QIOs) and Medicare quality metric programs.

I spend most of my time these days working with an amazing team of individuals across the Center to keep the residents of nursing homes safe. This is a major challenge given the rising levels of COVID in the community, congregate living and staffing issues. The team is developing guidance and working with our federal partners to ensure that the homes having testing and know how to use it. We are also working with our QIOs to ensure that the nursing homes have the education and instruction they need to implement best practices.

I also work with our teams to write regulations and providing guidance to survey organizations like organ procurement organizations and The Joint Commission. Every day is a learning experience and fortunate to have a phenomenal team. Importantly, my appointment is non-political and therefore I will stay in place with the change in administrations.

You’ve served on a variety of ASA committees, too. In what context do you feel you were able to make the greatest difference, either for the organization or its members?

I am most proud of my work on the Brain Health Initiative. I was able to use my policy interests and experience. I believe we engaged with lots of specialty societies and patient groups such as AARP. I believe it was extremely important for our patients and therefore showed our leadership to the community.

What do you consider the traits of the ideal resident? The ideal mentor?

The ideal resident is one who takes personal responsibility and is willing to be open and learn from mistakes. This is harder than people think. The faculty is ultimately responsible for patient care, but residents need to be willing to say what they know and do not know and ask questions. If poor outcomes or mistakes occur then they must have the personal psychological safety to accept feedback and use it as a learning experience.

Mentors need to be good listeners and guides. They must understand their mentee goals and not project their own goals for the mentee upon them. They also need to be good sponsors and help mentees advance by extending their imprimatur to them.

What’s one thing your students don’t know about you but would be surprised to find out?

They would be surprised to know that I initially wanted to be a transplant surgeon and researcher. I actually started a surgery residency with a fellowship spot at Minnesota but decided in the middle of the first year that it was not for me. I went into anesthesiology to do critical care but found I loved practicing anesthesiology, despite being less interested during my medical school rotation when I was focused on becoming a surgeon.

You’re the author of an impressive array of books on anesthesiology. What’s your advice for members who are looking to get published (books and/or journal articles)?

Persistence. I still remember how many times a paper was rejected, I would learn from each review and make it better. I always tried to ensure that my papers had a complete story and recommendation as opposed to publish the maximum number of papers. It is also important to know your audience and structure any paper or book for that audience. If you look at some of my books, I thought a great deal about the structure of the chapters from the readers perspective.

Is there anything you’d like to add that we haven’t asked about?

I still enjoy clinical practice and it is important to continue your clinical practice even in leadership positions. While I was a chair, and even now as the CMO of CMS, I still practice clinically. It makes a difference when you ask others to do the work.

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