Tips for Medical Directors
If you choose to accept a medical directorship at a nursing home, medical clinic or other facility, you must be prepared to assume substantial professional responsibility for the care delivered at the facility or clinic.
Be careful when you see advertisements for a "medical director" where it is promised that you will not have to be present or do much work at all in exchange for your monthly payments.
As medical director, patients (both your own patients and the patients of other attending physicians) and their families count on you, and State and
Federal authorities may hold you accountable as well.
To do this job well, you should:
• actively oversee clinical care in the facility;
• lead the medical staff to meet the standard of care;
• ensure proper training, education, and oversight for physicians, nurses, and other staff members; and
• identify and address quality problems.
Case Examples of Medical Directorship Issues
Medical Directorship Is Alleged to be Payment for Referrals
A physician group practice paid the Government $1 million and entered into a 5-year Corporate Integrity Agreement to settle alleged violations of
the AKS, FCA, and Stark law related to medical directorships with a medical center. Allegedly, the agreements were not in writing, the physicians were
paid more than fair market value for the services they rendered, and the payment amounts were based on the value of referrals the physicians sent to the
medical center.
Two orthopedic surgeons paid $450,000 and $250,000 to settle allegations related to improper medical directorships with a company that operated a diagnostic imaging center, a rehabilitation facility, and an ambulatory surgery center. The company allegedly provided the physicians with valuable compensation, including free use of the corporate jet, under the medical directorship agreements, which required the physicians to render limited services in return. The agreements with the physicians allegedly called for redundant services and served to encourage the physicians to refer their patients to the facilities operated by the company
Medical Directorship Is Alleged to Have Allowed Non-Health Care Provider to Operate Medical Office
A management company and non-health care provider who ran a medical practice hired a physician to be the "medical director" for a flat fee of $4,000 per month. The physician visited the medical practice less than once a month, did not hire or approve hiring of any of the medical staff, failed to review or create proper policies and procedures, and was not aware that there was the unlicensed practice of medicine occurring at the clinic. There was a criminal investigation of the unlicensed practice of medicine and a Medical Board investigation for unprofessional conduct.
Medical Director Sued Individually After Physician Committed Sexual Battery on a Patient
A community clinic had a physician who improperly touched a patient in a sexual manner not for medical purposes. The medical director was sued individually for negligent hiring and management. Thus, a medical director can be held civilly liable for human resource decisions. The same can happen in a wrongful discharge employment case. Most smaller clinics do not have employment insurance and this can be a liability if the medical director is hands off.
Conclusion
Medical Directors can serve an important purpose for nursing homes, medical clinics, surgery centers and other providers. There are limits to how many clinics a physician can supervise. Supervising a clinic or facility when the physician does not have background in that field can create its own host of issues. For example, a radiologist supervising a cosmetic aesthetic medicine clinic. A cottage industry has grown of physicians serving as medical directors for multiple facilities and both the facilities and clinics should demand more of their medical directors and medical directors should realize the scope of their liability.
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