The role of Medical Director is one that has evolved over the past decades; requiring M.D.’s to assume greater and greater levels of responsibilities, leading to burnout and a high turnover rate for both provider and payer organizations -a problem accelerated in the era of health care reform. The answer for many has been partnering with an accredited independent review organization (IRO). Take a closer look at the evolving role of medical directors, and its impact on provider and payer organizations.
While medical directors used to work with a clinical focus, now their focus must be split between clinical and strategic factors. They’re required to drive quality improvement, physician and patient satisfaction, and align clinical goals with the financial impact for the organization.
On top of these factors, today’s medical director must also provide leadership and expertise related to health insurance programs including, but not limited to, quality improvement, utilization management, network design, policy development, accreditation, credentialing, care delivery, and working in a team/collaborative relationship with other organization leaders.
And, according to Managed Care Magazine, some plans also want their medical directors to be “Involved in many extracurricular activities, such as meeting with specialty groups, serving on multiple internal committees, visiting practitioners and hospitals, all the while being responsible for time sensitive turnaround cases without coverage from your peer physicians, which creates a huge amount of stress and job dissatisfaction.1”
The article goes on to quote Thomas J. DeLong, PHD, who points out that medical directors are high performers and that they burn out the way high performers in most professions burn out.
And, according to Marla Tobin, MD, a recently retired senior medical director at Aetna, “Physician burnout in the medical community is rampant -especially in the boomers. The medical director community sees burnout, too and it often involves two main issues -task work and travel. Especially with the utilization review work and completing tasks in the queue, often physicians get into a production mode and have little personal contact or job satisfaction, as their feedback loop is often negative.”
All of these added pressures have contributed to the current medical director turnover crisis, a crisis which is costing provider and payer organizations greatly in efficiency, ability to handle fluctuating caseloads, and higher recruitment expenses.
The answer for many provider and payer organizations alike has been outsourcing to an accredited independent review organization (IRO). In fact, statistics show a 20% increase in outsourcing in the past three years.
Outsourcing complex case and claims review takes the pressure off of the Medical Director and allows them to focus on more value-added activities. Additionally, a partner IRO can bridge the gap and provide medical director services for healthcare organizations that cannot justify the expense of hiring one full-time. For others, who lack the resources to recruit, credential, and manage qualified physician staff an IRO can solve these problems by providing flexible Medical Director and Physician Advisor review solutions.
Improving internal productivity, decreasing medical director burnout and its associated recruitment expenses, and streamlining the claims review process are all benefits reaped by organization, which have turned to outsourcing.
Contact Us to explore how AllMed can help you overcome the current medical director crisis and ease the pressure.