In reality Tamara's to affect doctor (2,1,6,2,4)
I believe the answer is:
as a matter of fact
'in reality' is the definition.
(I've seen this before)
'tamara's to affect doctor' is the wordplay.
'doctor' is an anagram indicator.
'tamaras'+'to'+'affect'='tamarastoaffect'
'tamarastoaffect' with letters rearranged gives 'AS A MATTER OF FACT'.
(Other definitions for as a matter of fact that I've seen before include "Actually" , "in reality" .)