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Class Description:

PHYSICIAN EXECUTIVES

This class refers to physician executives as being medical directors of HMO’s and other such Managed Care Organizations. Some physicians might think that these medical directors are basically the judge and the jury when it comes to overseeing what physicians are doing with a specific patient. This class identifies characteristics of a physician executive as compared to clinical practice. Also, this class defines responsibilities of a HMO medical director and analyzes implementing medical practice guidelines from a physician executive’s perspective.

Topics:   

PHYSICIAN EXECUTIVES

I. KEY SKILLS FOR PHYSICIAN EXECUTIVES

II. MEDICAL DIRECTORS

III. TECHNIQUES USED BY PHYSICIAN EXECUTIVES TO GET CONTRACTED PHYSICIANS TO FOLLOW RULES

IV. EXAMPLES OF WHAT HMO’S MIGHT LOOK FOR TO RECRUIT OR CONTRACT WITH PHYSICIANS AND HOSPITALS

V. ACCREDITATION ISSUES INCLUDING HEDIS/NCQA

VI. PHYSICIAN MANAGERS OF THE FUTURE

Key Objectives

  1. Identify characteristics of a physician executive managing health care organizations.
  2. Define responsibilities of a systems-based practice medical director.
  3. Analyze implementing medical practice guidelines from a physician executive’s perspective.

Review

  1. Describe the typical combination of skills and personality characteristics for physician executives managing health care organizations.
  2. Examine responsibilities of physician executives.
  3. Synthesize how patient care pathways effect physicians including the impact of patient care pathways on payment for services rendered.