If you’re not familiar with the role of the physician advisor, then grab a seat and some popcorn. This may be of interest to you. To introduce this exciting opportunity, I’m reaching back in time (and horribly dating myself) to a scene from the film, The Graduate. Benjamin (Dustin Hoffman) doesn’t know what he’s going to do for a career, and he receives some unsolicited advice from Mr. McGuire…
Mr. McGuire: Come with me for a minute. I want to talk to you.
I just want to say one word to you. Just-one-word.
Benjamin: Yes sir.
Mr. McGuire: Are you listening?
Benjamin: Yes I am.
Mr. McGuire: Plastics.
Benjamin: Exactly how do you mean?
Mr. McGuire: There is a great future in plastics. Think about it. Will you think about it?
Benjamin: Yes I will.
Mr. McGuire: Enough said.
I want to say just one word to you. Well, make that two – Physician Advisor.
I may be going out on a limb here, but I’m going to wager that the role of the physician advisor could become analogous (in its own way) to what plastic became for us – something we wonder how we ever did without.
What makes me think this?
I just returned from an inspiring conference put on by the National Association of Physician Advisors in Orlando. The buzz was palpable. With the massive changes in healthcare delivery, physician advisors are greatly needed to be the bridge between clinical staff and hospital administrators. Increased regulations, ICD-10 implementation, the change to accountable care and an increasingly data driven model, are all creating a demand for doctors who can assist as advisors and liaisons. Physician advisors wear a number of different hats, being involved in areas such as patient quality and safety, length of stay, documentation, appeals and utilization management. The role of the physician advisor first became recognized in 2005, although physicians have been working in this capacity for much longer.
Dr. Howard Stein, one of the conference speakers, started working as a physician advisor in 1993 while he was practicing as a family physician. Over time he transitioned out of practice and into fulltime work as a physician advisor for his hospital. In the Physician Advisor 101 workshop, he told us about his typical day. He rounds with the doctors in the morning and then meets with case management teams for multidisciplinary rounds. He knows every patient in his 270-bed hospital and is involved in ensuring quality care, compliance and communication among staff. The afternoon is spent on denials, meetings and other responsibilities. His job is a delicate mixture of diplomat, clinical expert, administrator and keeper of the peace. Although he uses his clinical skills every day, he is not directly responsible for patient care. His days are typically 7 am – 4 pm.
Dr. Bernie Ravitz, a physician advisor for Medstar Good Samaritan Hospital, didn’t mince words on what’s required of someone in his position, “You are going to deal with a lot of conflict.”
To be effective as physician advisor, Ravitz recommends a broad background in Internal Medicine (IM), Family Practice (FP), or Emergency Medicine (EM). The physician should be experienced with outpatient and inpatient medicine, have strong communication and interpersonal skills, and be trusted and respected by other physicians and staff. He sees education as an integral part of his job, helping physicians with documentation and difficult cases, offering feedback to reduce denials and improve care. Ravitz finds that showing physicians data can be useful in finessing relationships where physician behavior needs to change.
The third presenter in the Physician Advisor 101 course, Dr. Bradley Shumacher, is also a proponent of using data. He remarked, “One of the best things I did was go back to business school. When they [administrators] are looking at spreadsheets, statistics, and numbers, I can better participate in and understand these conversations.” A new area Shumacher is now involved in is setting up a residency program and developing quality-based care initiatives.
These three speakers all work full-time in their hospitals, but there are other options. Some physicians start out working one day a week doing utilization management or appeals. Others may work for a company that contracts with hospitals and other organizations to handle appeals and utilization review. Additional specialties besides IM, FP and EM have found niches within the physician advisor position. I know of pediatricians, surgeons, anesthesiologists and others who are working in this area.
How does one get started as a physician advisor?
- Shadow the physician advisor at your hospital (if you have one)
- Serve on committees for quality, safety or ICD-10 implementation
- Start doing appeals or utilization management
- Attend physician advisor conferences and boot camps
- Search on job boards for “physician advisor” positions
The president of The American College of Physician Advisors, Jeffrey Epstein, MD, is on fire with enthusiasm and passion for establishing the physician advisor as a highly respected and integral part of the healthcare team. As he describes it, the mission of the physician advisor is, “To be honest and transparent; to do all we can to help our new healthcare system move forward while improving quality, value, patient satisfaction, and provider satisfaction. We are provider advocates and we feel we have an important role to play in the efficiency of care, quality of care and helping populations stay healthy.”
In case you’re not convinced of the importance of the physician advisor role, let me share a story Stein recounted. While he was mingling at a hospital function, someone came up to him and said, “I heard you’re worth 11 million dollars to the hospital!” Stein knows there is a great ROI (return on investment) for physician advisors, but he had no idea he was worth that much. “Now if only I could work for a percentage!” he quipped.
There is a great future in the physician advisor. Think about it. Will you think about it? Enough said.
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[…] the length of a patient’s stay, proper documentation, and appeals and utilization management. A physician advisor’s typical day may consist of doing rounds with doctors in the morning, then meeting with case management teams […]
Dr. Fork,
Fabulous article! I’m filling two full-time Physician Advisor roles in IL. From a talent acquisition perspective there’s becoming a huge demand for docs with this skill set.
I have lots of interested physicians. But few who have hospital based experience. Unlike the well known firms, our job allows our PAs to round, coach, mentor… versus just doing review work and talking by phone.
Pay is mid $200k range. Not $11MM, but great work life balance… M-F dayshift. Maybe recruiters should get a percentage for finding top talent too… LOL. Anyone interested in learning more, please call me. 🙂
Looking forward to getting your next blog entry!
Krista Grant
SR. PHYSICIAN RECRUITER, Talent Acquisition and Management
Presence Health
200 S. Wacker 11th Floor | Chicago, IL 60606
Office: 262.289.2103 | Cell: 318.572.8579 (After hour calls & text messages are fine)
Email: krista.grant@presencehealth.org
http://www.presencehealth.org
Krista, thank you so much for your enthusiastic reply and kind comments! It’s great to hear about these positions you have for physicians who want to have more of an integral role as advisors. I appreciate having your contact information. Hopefully we can team together to create some win-win matches for your clients and my readers! Please feel free to keep us updated on your opportunities for doctors.
Hi I just recently signed up a job which requires me to be both hospitalist and physician advisor. I have mentor at hospital and she is very helpful. I am trying best to understand my role and improve myself. As mentioned in your article, not an easy job . I would really like to learn more about role of PA in a community hospital setting . Opportunities to gain more knowledge and acquire skill set needed for this job. can you recommend, good articles, books or online resources that could help. I have joined NAPA . Any help is highly appreciated. thanks
Thank you very much for your post and question. Since I wrote that blog, a new organization formed, The American College of Physician Advisors. This is a great group of dedicated folks who will be happy to help you. There are resources listed on their site: http://www.acpadvisors.org/. Let me know if this does not provide you what you are looking for. I wish you all the best. Please keep in touch.
Great article! I am a Neonatologist and worked for EHR!! And did a fantastic job and learnt a tremendous amount as well. I didnt see a disadvantage being a Pediatrician..in fact it was a huge advantage!!! I
Lakshmi, I’m so glad your experience at EHR worked out so well. I appreciate your input on how being a pediatrician was beneficial in your role. If I may ask, are you still working in the capacity of a physician advisor? Thanks for reading and commenting.
Hi Heather! I took a break for a couple of years for personal reasons however back in the market now. Many Pediatricians work as physician advisors. This is what I was told…its about critical thinking and determining acuity hence it specialty is irrelevant. As a Pediatrician I could review more objectively rather than as a treating physician. I also trained in India…and we couldnt graduate without a strong foundation in IM/Surg and OBGYN so that helped as well. Hope I have answered that question.
Hi Heather
Your post was so great and motivating. I have been a general practitioner for many years but am looking at going into the advisory field, maybe research advisory or legal. I am looking and so confused as to where to start…. and I am based in Australia. Any ideas or contacts that you may have on my end of the world?
Thanks
Ushma
Hello Ushma, Thank you so much for your kind comments. It is normal to be confused when starting this process of considering options outside of practice. If you can do some networking and try to connect with physicians who are working in these potential areas of interest, such as advising, research or legal, they can provide a wealth of information about what their jobs are like and what it takes to make a transition. You might also like to read this short book by Dr. Michael McLaughlin, “Do you feel like you wasted all that training?” While the author focuses on his own transition from plastic surgeon to medical communications, he gives advice on how to go through the process and think about your unique situation. I do not have any specific contacts in Australia, but I do work with physicians in your area and have two I am currently partnering with.
Dr.Fork,
I have 12 years of out patient experience. Is there a quick and easy way to get trianed as a physician advisor? I guess the certifiation may add some weight on my CV, in case I do plan to apply for this poisition in the hospital I have been working for last 10 years.
Thanks!
Tahera.
Hello Tahera, there are not any super fast ways to become trained as a physician advisor, as there is a lot to learn, and some jobs require you to wear more hats than others. I have had clients who are hired by their hospital system and then they go to a variety of physician advisor conferences and boot camps to learn, in addition to having an experienced physician advisor mentor from outside the hospital. Other clients have been hired by third-party companies doing remote PA work and they are given specific training by the company. If you want to increase your knowledge, you can attend some of the PA conferences and boot camps. Good luck!