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Home > Resources > eNews > August 2000 Part2 |
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The Managed Care Insider eNews Volume Two Number 7 August 2000 PART TWO of TWO Welcome to The Managed Care Insider eNews. You are receiving this because you have subscribed; the eNews is never sent unsolicited. Subscribe/unsubscribe information can be found at the end of this eNews. The Managed Care Insider eNews is published, copyrighted, and owned by The Scheur Management Group, Inc. (SMG), http://www.scheur.com and is distributed monthly, free to subscribers. If you wish to forward this edition, you may do so only if the edition is forwarded in its entirety. No reproduction of any part of this publication is permitted without the express permission of the publishers. ---------------------------------------------------------------- In Part One of this Insider eNews issue, Barry Scheur identified the medical director's "no-win" situation between management and members ("Where Have All The Good Docs Gone?"). His article's conclusion is featured here in Part Two. Next month, The Managed Care Insider eNews will address the employer/employee relationship: What works. As always, we invite you to send us your comments to insider@scheur.com. ---------------------- Insider Vision By Barry S. Scheur, President, Scheur Management Group; Chairman, Venture Health Partnership Group WHERE HAVE ALL THE GOOD DOCS GONE? An Ode to a Needed New Breed of Medical Director (Continued from The Managed Care Insider eNews, Vol. 2 n7, Part One) We need real physician leaders who are not satisfied with simply taking refuge behind the cloak of corporate policy, but who are given the authority and the encouragement to meet with, educate, and debate the medical community, and then implement policies governing administration, care delivery, reimbursement and quality of care. Certainly, there is a need for physicians who analyze data and make utilization review determinations, but that is not the greatest responsibility for a medical executive in the new world of managed care. It is as a communicator, marketer, and standard setter! Just about all community hospitals have hired vice presidents of medical affairs. While part of the management team, they are required to represent medical staff views to management, to serve as a conduit for information collection and dissemination, to balance the delicate areas of hospital and community politics. For all of the difficulties in making this role effective, this is a model that I think should be replicated, albeit with modifications, in the managed care industry. We need to accord physician leaders the respect and latitude they deserve as key members of the management team. The provider network is the product that is sold. The medical directors and their constituents, the physicians, are the key players in ensuring that the product we sell is indeed the product that the member gets. To demonstrate how these new roles can be implemented successfully in health plans, for the benefit of multiple constituencies, Venture Health Partnership Group (VHPG), the company that Scheur Management Group founded to purchase and turn around failing HMOs, is redefining the jobs of our chief medical officers. We are mandating their focus change to reflect the challenges of the new millennium. VHPG's chief physician executives will meet with employers and community leaders and explain to them, cutting through all the intellectualized verbiage, about treatment protocols and clinical relevance, why our health care plan works more effectively for members and physicians, as well as finding out what we need to do better. We need passion, energy, eloquence, and boldness in physician leadership. And we need their acceptance as executives by both their constituent docs and the health plans they represent. Then we will provide them the necessary economic means and decision-making authority, given the responsibilities we are placing on them. We think that the managed care industry may need to retrain current medical directors to fill this new role because that's what's needed to rebuild the reputation -- and the performance -- of our industry. -------------------------------- Sites and Sounds on the Net: SMG has no ownership of, nor does it endorse the following sites. This information is presented as a resource for subscribers. In keeping with this issue's focus on the role of medical directors, we present the following sites which cover these areas. The American Medical Directors Association can be found online at http://www.amda.com/ Visit the Association of Medical Directors of Information Systems (AMDIS) online - a professional organization dedicated to the promotion, development and sharing of information between physicians responsible for organizational leadership in information technology at http://www.amdis.org Want to participate in an email discussion group solely for and among Medical Directors of MCOs? Find out more at http://www.mcoexecutives.com . Look for the link to "Medical Directors Only." ---------------------------------------------------------------- End of PART TWO of TWO, The Managed Care Insider eNews, Volume Two, Number 7. Scheur Management Group (SMG) is one of the most experienced specialized healthcare operations management and business revitalization consulting firms in the country. Our expertise is in time-sensitive analyses, strategic business and market planning, operational re-engineering, and communications, as well as implementation of start-ups, expansions, and new products. The firm's clients cover the spectrum of insurers, managed care organizations, physician groups, integrated delivery systems, hospitals, employers, governmental entities, vendors, and other providers. Contributing to this edition is Barry Scheur. Editing and Research by Judith Jaffe. Production Coordination by Nancy K. Belle. TO SUBSCRIBE: visit http://www.scheur.com/smghome.nsf/webcontent/ezine.html or send e-mail to insider@scheur.com with the word SUBSCRIBE in the subject and name, email, company, title, and country in the message. TO UNSUBSCRIBE: send email message to insider@scheur.com with the word UNSUBSCRIBE in the subject. Please take a minute to visit our eNews page at http://www.scheur.com/smghome.nsf/webcontent/ezine.html for archives, subscriber information and to RATE our ezine. Get up-to-the-minute health care news on-line at www.scheur.com |
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