Q : What changes are needed when an occupational health program becomes blended with urgent care? Does the medical director’s role change?
A: “We have a dedicated occupational medicine clinic that our medical director is responsible for, but we have a number of workplace clinics that our own employees utilize. So there’s some blending there and our medical director is responsible for all of them.”
A: “A medical director is a medical director is a medical director; the rules are governed by the standards you develop within your organization’s clinic base. So you might have a medical director who’s certified in family practice or occupational medicine [taking] responsibility for a multitude of services. Your medical director should maintain his or her own individual role within the scope of care”
Q : We talk about population medicine – does this approach require a medical director from a family practice orientation?
A: “No. Population medicine addresses the community members you serve. It looks at the needs of the community and ways to optimally provide medical care to meet those needs.
A: “You can look at the risks, define the educational and healthcare needs, and look at the diseases in your community. Many physicians can address those issues, as well as nurse practitioners.
Q : I know a number of programs have successful program/medical director teams and for those of you on the call, are you willing to share some pearls of wisdom for making these successful partnerships?
A: “Speaking of population health, it’s more about wellness and prevention and how the physicians interact with the patients.”
A: “…with population health, they are more interested in the occupational health programs because we can bring business to the hospitals. We have employers that have on-site clinics that do physicals and flu shots, and the businesses really like that.”
Q : What is the value of having your program’s medical director provide educational programs to other physicians in the health system?
A: “It is a great [benefit] when our medical director does that––especially when there aren’t occupational medicine physicians in that practice. New physicians going into the field benefit from the camaraderie and ideas shared by the seasoned physicians.”
A: “It is important to share the expertise with those not familiar with the field. It’s also important to get your medical director out there; if [other physicians] have an issue, they will feel more comfortable connecting with him.”
A: “Our physician/medical director is directly responsible for recruiting physicians for workers’ comp. We have a specific orientation process which includes our mission and vision.
A: “It’s a very strong role for our medical director [to play], teaching, sharing, and collaborating throughout the system.”
Q : Who is responsible for the network of providers, the medical director or the program director?
A: “From an occupational medicine perspective, if it’s related to medicine, it’s the medical director.”
A: “I recently had a hospital occupational health program that was telling the clinic exactly who to refer to. They want you to use this group, or MRI, or rehab group. If you are going to set up a network of care, it’s important to have guidelines and outcomes.”
A: “The physician should be looking at who is taking care of their patients; that can be challenging in a large healthcare system.”
A: “When our medical director developed guidelines for our network, we struggled with how clinical we should get. We settled on access and communication with employers, return-to-work orientation, prescription meds, and those kind of things, versus the more clinical aspect.
Q : Our medical director is extremely well paid, so much so that it jeopardizes our ability to make a profit. How might I address this?
A: “We have a well-paid medical director but he’s also a working physician and provides leadership. You get what you pay for and if someone needs to step into a leadership position, they need to get paid more. You can look at other areas in your clinic budget that can be cut back.”
Q : What lessons have others learned in developing a medical director/ program director interface?
A: “All staff should be a part of the team and identify their team roles.
A successful program has teams that work together and are not placed in silos within the clinic structure.”
A: “We have weekly and monthly meetings that give these directors the opportunity to show their leadership and get involved. If you have to force somebody to interface, they are probably not the right person. You need to look at all the services you provide and that person needs to be a cheerleader for that business.”
A: “It takes everybody in the clinic, no matter what your pay grade is.”
A: “There needs to be a lot of daily contact between the medical director and program director. Sometimes we need to circle back and build in regular time for close communication.”
Q : What can a medical director do to ensure a stronger interface?
A: “He or she needs to communicate on all levels and work as a team, talk about the good and bad. If you don’t bring [negative] issues up, you’re going to have a problem. No matter what the subject is, you [have to] put it on the table and work it out.”
A: “You need goals for the program or clinic, so you can all move forward together towards [the same finish line].”
