The Transition from Medical Directorship to Clinical Leadership
For many years, hospitals have sought assistance from physicians in helping manage clinical departments. This assistance has come primarily in the form of medical directorships. In the traditional medical directorship, the physician attends departmental meetings and provides clinical input when asked. Generally, the physician tracks the hours spent and is compensated at an administrative rate of pay.
Hospitals are seeing more of a movement toward quality-based reimbursement and bonuses or penalties based upon performance against quality metrics. For this reason, hospitals have recognized the need for greater assistance and more clinical input from the physicians on their medical staffs.
In response to the increased need for physician input, hospitals are rethinking medical directorships and are transitioning them to clinical leadership positions. In some cases, the clinical leadership positions resemble the old medical directorship positions. However, clinical leaders are more involved in day-to-day management of the service line, typically requiring more hours from the physician. These arrangements usually have some portion of the compensation at risk or a bonus available, based on achievement of quality-based metrics.
Because these arrangements are fairly new, it remains to be seen if they will result in the quality improvement goals sought by the hospital. However, hospitals that wish to be on the leading edge should consider implementing the clinical leaders model in place of their current medical directors. This will best position them for likely changes coming down the road from governmental and commercial payors.
