Medical Director’s Behavior Change

My coffee with an old medical director colleague turned into lunch on Friday and, alas, I was late picking up my daughter! I will say that medical directors offer a fascinating study in human behavior. They spend have their adult lives treating kids and families in tiny offices with brown paneled waiting rooms and then make life or death decisions from the front seat of their Buick LaSabres. They are very much knee deep in figuring out what’s necessary, what went wrong with a patient and why the lab tests say one thing but the patient’s behavior says another. They don’t easily bend, and almost always play the role of skeptic. That hasn’t changed. Nor has their attire. They still wear checkered button-downs and jeans on Fridays and bulky sweaters on Tuesdays, but instead of oversized wallets with pictures of their kids, they carry giant iPhones with photo montages of their grandkids, and their experiences with those kids – their asthma, their autism, their substance abuse – have a profound impact on how they spend their days. These family experiences have great influence on their decisions about what’s medically necessary — much more than you’d think and much more than they used to. Medical directors do well when they are in competition with something, too – be it a Sunday morning basketball game with colleagues or trying to achieve the lowest rate of readmission among patients with chronic obstructive pulmonary disease. They are creatures of competition, inspired to get to the best outcome as quickly as possible and this competitive spirit is partly why so many are more willing today to change course and consider new methods of treatment or new protocols to address long-time medical issues, like substance abuse. This changing mindset is a function of time and having seen and experienced how patients behave over many years. But it is an interesting change that will be important to follow, particularly as the medical directors of the future have more access to data than their predecessors did. At lunch on Friday, Dr. Kenseth ordered a cobb salad and an iced tea; 10 years ago it was pastrami on rye and a cola if I recall. For all the ways Kenseth and others have had to change, they remain at the forefront of trying to help their organizations, physician colleagues and families get on the same page. One of my favorite interviews is with Dr. Barry Lachman, because 15 minutes with Dr. Lachman invariably becomes 1 hour. Here’s a snippet from an old interview to give you a feel for that, and for how medical directors are trying to get all of us on the same page. Click here

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