Hospital news

Medical leadership positions carry responsibilities and risks

By Vanessa Orr

Although it may seem like becoming a medical director of a facility is an easy way for a physician to earn extra income, the position comes with a myriad of responsibilities, including ones that physicians may not be aware of. .

“A lot of physicians believe that becoming a medical director won’t take a lot of time and will require very little effort,” said Bill Gompers, CFE, producer, Risk Strategies Company, Danna-Gracey. “How wrong they are if it’s done well.”

Bill Gompers, CFE

Depending on the specific arrangement, the duties of a medical director may be extended. “Before accepting the position, it is essential that physicians understand the legal, regulatory and professional liability issues involved in the particular medical direction they are considering,” Gompers said.

In some places, medical directors are required to provide patient care, while in others they are not. Duties may include accreditation; ensure that the practice complies with the regulations; develop and implement protocols, policies and procedures; checking standards and supervising any auxiliary personnel; conduct file and peer reviews; perform administrative duties necessary for licensing and board requirements, and provide general practice oversight, among other things.

“What some doctors might see as a way to supplement their income for very little effort is actually taking on a great deal of responsibility if they perform the required tasks in the necessary way,” Gompers said. “In fact, in some states, including Florida, failure to meet these obligations as defined in state law could have an effect on their medical licensing status.”

While certain duties of a medical director may be delegated, the medical director may be held liable when a patient experiences an adverse event or the entity’s regulatory compliance is called into question.

“Many physicians don’t realize that their medical malpractice insurance policy most likely excludes medical director-initiated duties,” Gompers said. “In order to protect themselves from any lawsuits or problems, they may need to obtain a separate policy or be added to the policy of the facility where they hold the position of medical director.”

There are a number of red flags that may signal a problem when reviewing a medical director agreement.

“For example, if a person is a medical director at a facility like a nursing home and refers patients there while receiving a monthly honorarium as a medical director, he or she may be violating anti-bribery regulations.” , Gompers said.

The Physician Self-Referral Act, commonly referred to as the Stark Act, prohibits physicians from referring patients to receive “designated health services” payable by Medicare or Medicaid from entities with which the physician or member of the immediate family has a financial relationship.

“If a doctor does not ensure that auxiliary staff meet their continuing education requirements and are properly trained or that all professionals in the facility are properly licensed, they can also be held responsible if something happens” , Gompers added. . “In the state of Florida and elsewhere, the medical director is also responsible for ensuring that a facility’s billing procedures are appropriate and meet all requirements.”

In Florida specifically, any licensed health care clinic cannot operate without the day-to-day oversight of a single medical or clinic director, who is, in the view of the state, the focal point for maintaining high quality care. quality and guarantee of the operation of the establishment. in compliance with the law. When applying for recertification, medical directors will be reviewed by the state as part of the licensure requirement, and if there is a complaint about the facility, every facet, including the role of the medical director, will be reviewed.

“Anyone considering entering a medical branch should have a contract and consult with a health care attorney to ensure that the proposed business arrangement does not violate any state or federal laws such as the practice of medicine in business and the terms of payment,” Gompers said. “They need to make sure they understand their obligations under the contract and determine if they can meet those obligations appropriately.

“They should also ensure they have their own liability coverage to protect them in this role, or ensure they are included in the policy of the facility or clinic hiring them and obtain a certificate insurance as proof of that,” he added. “A number of physicians don’t realize how important this role is to the facility and how exposed they can be.”

For more information, contact Bill Gompers at, (888) 777-7173 or visit

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