A physician executive in action
Dr. Romeo Divinagracia outlines the duties and responsibilities of "someone who spans the boundary between a full-time administrator and full-time clinician"
By Mabelle Aban, Contributing Writer
An adviser, health-care enhancer, resource manager, and key clinical motivator for the hospital-these, Dr. Romeo Divinagracia said, are just some of the key responsibilities of a "physician executive."
Addressing the 34th annual convention of the Philippine College of Physicians, Divinagracia said a physician executive is "someone who spans the boundary between a full-time administrator and full-time clinician." This is in contrast with a "physician manager," who is a full-time executive with no clinical experience; and a "clinician executive," who may be a nurse or a dentist.
He categorized the professional activities of physicians with regard to patient-care administration into primary, secondary, and tertiary. "Primary" means few administrative responsibilities usually given to a younger physician. "Secondary" is when a practitioner spends less than half of his time on executive/administrative matters. The young and the middle-aged usually fall under this category. "Tertiary" is used to describe physicians, usually older, who handle predominantly administrative responsibilities.
Other categories of a physician executive include managers who posses the MD degree but whose administrative responsibilities do not involve clinical expertise at all. It may also include p;racticing physicians with minor administrative functions and other activities involving only little time.
Divinagracia said, however, that there is little data on just how much administrative work a physician is engaged in." Still, "there has been a growing importance in balancing professional and managerial issues in the health-care organization," he said.
The physician executive's roles
In a health-care organization, a physician executive's roles include general management and governance, improvement of medical practice within the organization, evaluation of physicians' performance, resolving problems among physicians, recruitment of physicians, and setting organizational medical policies. He or she may also be involved in ensuring quality control, peer review, taking leadership in controlling patient-care costs, and ensuring that medical practice is in accord with ethical principles.
He stressed: "A physician executive provides leadership in management roles that require clinical expertise." He or she is also viewed as a visionary leader in health care, in such a way that "he challenges the accepted ways of doing things and enlists others in seeing the future as [he does]."
Divinagracia highlighted certain areas in which a physician executive is found to be most effective. These are in advising chief executive officers, chief operations officers, and governing boards; forging stronger relationships between doctors and administrators; enhancing quality care; influencing resource utilization; technology assessment; and in developing relationship with area medical schools.
Contributions and main responsibilities
A physician executive also has to make three most significant contributions. First is in resolving potential conflicts between management and medical staff. In special circumstances, he or she may act as a facilitator between hospital management and staff.
Second, a physician executive contributes in ensuring quality care and wise resource utilization. He or she actively takes part in developing clinical protocols and critical paths, health-care delivery and case management; coordinating service line; initiating care and disease-management programs.
Lastly, he or she contributes in physician recruitment and education; counseling and disciplining physicians; and strategic planning, leadership, and problem solving.
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