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Medical affairs leaders play a vital role

Medical affairs leaders make up an important element of the health-care system that the public hears little about, says Toronto health lawyer Kate Dewhirst.

“When we look at hospital leadership and management, we often think of the president and CEO, chief of staff or the chiefs of department,” she tells AdvocateDaily.com.

“Medical affairs managers are often overlooked. They do so much work behind the scenes to liaise with professional staff members and to gain their perspectives. They often have to navigate complex internal political issues and act with finesse." 

Dewhirst, principal of Kate Dewhirst Health Law, works closely with hospitals and their medical affairs leaders mainly to deal with physician issues and other professional staff, including dentists, midwives and nurse practitioners who are independent contractors. 

Medical affairs leadership can take a variety of different positions: they work in conjunction with the hospital president and CEO, chief of staff or chair of the medical advisory committee (the lead physician for the hospital), heads of department or heads of division. 

“They may be managers, directors or administrative people who come under the heading of medical affairs, professional staff affairs or medical relations,” Dewhirst says.

“There are administrative tasks and leadership required within hospitals that deal with all kinds of documentation and human interaction that is essential to a positive relationship between a hospital and its professional staff members.”

Medical affairs staff are administrative leaders who address these main issues:

  1. Human resource planning: developing and following a strategic plan for hospital needs for physicians and other professionals. This includes an analysis of who is expected to retire and where the hospital will grow its services;
  2. Recruiting: while the chiefs of department may look for the next top talent, the medical affairs personnel deals with the back-office responsibilities of bringing someone on (sending out letters, offers, contracts, enticements);
  3. Credentialing: making sure that professional staff members applying to the hospital have the right skills and are able to provide the services that the patient population needs;
  4. Privileging: taking the applications from the credentialing phase and bringing them forward for review by the medical advisory committee and the board;
  5. Managing: this is where much of the medical affairs activity occurs and is about communicating with the professional staff to ensure they are engaged in hospital issues. This could also involve orientation, training, continuing skills development, as well as making sure they understand hospital policies, any changes that happen and to receive their input in hospital planning;
  6. Addressing challenging issues: dealing with and responding to complaints and concerns about individual professional staff members (for example, a complaint about a physician relating to a negative patient outcome.) This could also include dealing with staff issues such as health, parental or educational leaves; and
  7. Exiting: involves retirements, resignations or when people are asked to leave the organization.

"This kind of role is complicated: it requires a great deal of human management skills to be able to listen, hear peoples’ concerns and to be clear about expectations and outcomes,” Dewhirst says. “It’s important for medical affairs leaders to be able to communicate in a way that people want to hear.”

They are also liaising with the hospital CEO or chief of staff to ensure they understand the perspective of the physicians, she adds. 

Often, medical affairs leaders are dealing with extremely challenging circumstances that can cover a wide swath of issues, Dewhirst says. 

“Some hospitals have 1,000 doctors working there and it can be a huge amount of work to manage those relationships,” she says. “Depending on the hospital, there’s a great deal of leadership that goes into communicating to the highest levels about who’s staying, who’s leaving and other physician-related issues.”

Dewhirst describes the work that medical affairs personnel do as “important” and that their main responsibility is to ensure the hospital employs the best possible professional staff for excellent quality health care.  

“They act as the liaisons between the doctors and the hospital,” she says. 

 

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