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Vol. 3. No. 3
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July/August 2001 |
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Three Steps to a Better Medical Director
by Paul Reich, M.D.
Modern day healthcare organizations hire medical directors for their clinical knowledge, business acumen and leadership abilities. The new medical directors come with impressive credentials, a doctorate in medicine and often a master's degree in business, healthcare or other related field. Many have years of clinical experience in primary or specialty care, often serving as leaders in their local medical community. However, many medical directors fail, as evidenced by the high turnover rate, particularly in for-profit health plans, and the dissatisfaction expressed by many currently employed in HMOs, hospitals and healthcare businesses.
Successful medical directors demonstrate expertise in three areas:- Clinical Knowledge
- Business Acumen, be it an HMO, hospital or Internet company
- Leadership Ability
Healthcare companies must improve their medical directors' training and experience in each of these three areas if they are to retain them and, at the same time, grow their business.
Clinical Knowledge
Although experienced in clinical practice, a medical director soon finds that he or she needs a wider knowledge of medicine than that obtained in the usual practice of medicine. Many of the decisions made by medical directors require familiarity with specialized procedures and therapies.
Right now, for example, knowledge of the capabilities of PET scans and how they can be used to deliver cost-effective care is essential, yet many medical directors never ordered one during their clinical years. Healthcare organizations deal with this by providing journals, conferences and desktop research capabilities. Allowing and encouraging their medical directors to take time to go to clinical seminars and interact with medical specialists also provides a means for them to update their knowledge base. Little gains more respect from a network or group of physicians than a knowledgeable medical director conversant about the latest advances in medical care.
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Business Acumen
Probably nothing frustrates healthcare organization CEOs more than a medical director with a vast clinical knowledge, but no concept of the company's business. Clinically based decisions almost always have a ripple effect throughout an organization. A medical director who continually approves payment for out-of-network procedures at a hospital, where its only claim to fame is better marketing, has not learned that healthcare premiums are based on whether the HMO's network is open or closed.
The American Association of Health Plans, the American College of Physician Executives and other professional organizations offer courses that train new medical directors and raise their level of understanding of the healthcare industry. These courses, plus weekly reading of trade magazines and other sources of industry information, should be encouraged by CEOs to prevent frustration. Mentoring by experienced and successful medical directors, whether in the organization or on a consulting basis, provides the best way to keep them abreast of the changes and innovations in healthcare.
Leadership Ability
To paraphrase a former and late leader of theU.S. House of Representatives, "Tip" O'Neil, "All leadership is local." The ability to organize and lead a local and small group of physicians often presages a physician who, with experience, can be the leader his organization wishes. The same skills, then, can be applied to the large network of physicians affiliated with an HMO or hospital.
Although some physicians are born with leadership capabilities and learn to use them to lead successfully in a healthcare organization, even they need to hone their skills in several areas. Dealing with difficult peers is an art in itself, but, with the help of mentoring and formal training, this management technique can be learned.
Probably most important and overlooked is the medical director's ability to speak effectively, to motivate change or to explain it. Only a few are exceptional in their ability to speak extemporaneously, but most can be taught to be concise, logical and rational. Most formal courses for medical directors include public speaking and they should be given every opportunity to speak to physician groups.
Rarely, does one see a medical director with all three skills -- clinical knowledge, business acumen and leadership ability. But with support, mentoring and training, most can become proficient in all. It is in the best interest of healthcare organizations to provide the means for their medical directors to develop these skills to the highest level possible.
About the author: Dr. Paul Reich is chief medical officer of VHPG and consultant for SMG. Dr. Reich is currently serving as the interim medical director of The OATH for Louisiana. His career spans 23 years as a practicing physician and eight years as a physician executive for Harvard Pilgrim Health Care, one of the leaders in health care innovation and care quality in the United States. As chief medical officer for SMG, Dr. Reich is responsible for coordinating SMG's clinical services to clients in the areas of medical management, disease management, quality improvement, financial accountability and the integration of information systems with medical management programs. |
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