Attending:      

John D. Rutherford, MB. ChB.   
W. Steves Ring, M.D.    
Paul Bergstresser, M.D.    
Stan Taylor, M.D.     
Luis Palacio, M.D.
Sharon Reimold, M.D.
Steven Leach, M.D.
Barbara Haley, M.D.    
David Khan, M.D.     
Bruce Mickey, M.D.     
Robert Ulrich, D.O.
Elliot Frohman, M.D.
Morris Bryant, M.D.
David Scott Miller, M.D.
Karen Bradshaw, M.D.
Jess Whitson, M.D.
Bradley Marple, M.D.
Michael Miller, D.O.
Jeffrey Kenkel, M.D.
Myron Weiner, M.D.
Dan Garwood, M.D.
Phil Evans, M.D.
Dana Matthews, M.D.
Paul Weatherall, M.D.
Clifford Simmang, M.D.
James Huth, M.D.
Carina Schwartz Dabney, D.D.S.
Julie Landesberg – ex officio
Stacey Rychtyk – ex officio
Judye Gremm – ex officio
Cindy Lochte – ex officio
James Adams – guest
Bill Christie - guest

Absent:
Leland Lou, M.D.
John Early, M.D.
Karen Kowalske, M.D.
Cecelia Brewington, M.D.
Patrick Clagett, M.D.
Gary Lemack, M.D.

I. Medical Director / Clinic Manager Subcommittee

 Dr. Rutherford discussed his plan to form a subcommittee consisting of 4  representatives each from the Medical Directors Clinical Operations Committee  and the Managers Clinical Operations Committee.  He provided each Medical  Director with an election form and asked that they rank the list (1-31) by order of  their participation preference.  He noted that members will rotate on and off to   assure that everyone has an opportunity for involvement.  

 Forms were collected at the conclusion of the meeting.

II. Status Review of Phase 1 Actions of Clinical Services Initiative

III. Stacey Rychtyk briefed the Committee on current Clinical Services Initiative  projects.  These include:
 
• IDX Mapping  where visit codes are being standardized and dictionaries are being updated and mapped to assure accurate reporting data once the scorecard is implemented.
• Phone Coaching and Monitoring.  Classes are being offered and strategies will be implemented to help employees utilize the etiquette stills that have been taught.

IV. Dr. Rutherford reviewed the Employee Healthcare Assistance program that will  be managed by Judye Gremm.   Committee members were provided the new  brochure that will be sent to all employees.   Dr. Rutherford explained that the  goal of this program is to recognize the importance of the University staff and  offer them special access service.

V. Dr. Rutherford presented the results of the Medical Director’s Questionnaire that  committee members were asked to complete.  He prepared and reviewed a slide  for each category.  He expressed his disappointment that in many cases the  results of this survey indicated minimal input and participation on the part of the  Medical Director in clinic operations.    

 Possible reasons for these results were discussed in depth and include:

• Medical Directors not empowered by their Chairs to take action on clinical operational matters
• Reports and financial information not being provided to Medical Directors
• No clear description detailing duties of the Medical Director
• Degree of responsibility of the Medical Director varies widely between departments
• Medical Directors lack the time necessary to be optimally involved in clinic operational matters given other faculty responsibilities (i.e. teaching, rounds, research, etc.)
VI. Discussion

 Discussion continued regarding our current clinic operations and ways to work  towards the concept of a group practice and achieve best practice standards. 

 Dr. Bergstresser shared his departments remedy to minimize “bumped”  appointments.  Faculty are charged $10 per bumped patient.  Bumping a full  day’s clinic could cost a physician $300.  He noted that  “bumped” appointment  occurrences have dropped 80% since this policy was initiated.

 Dr. Bergstresser emphasized the need for Chairs to realize the potential  profitability of their clinics if they are managed efficiently and carefully.  He and  Dr. Taylor noted that they discuss clinic operations with each other and their  faculty routinely and expectations are set for faculty and staff.

 Dr. Ring discussed the method in which managed care contracts are reviewed  and negotiated by UT Southwestern Health Systems and the Clinical Chairs.  He  encouraged the Medical Directors to be familiar with the various contracts and  how they impact their clinic’s business and hold discussions this with their Chair.   Drs. Bergstresser and Weiner agreed.  Both indicated their departments have  brought bad contracts for their clinics to the attention of the Clinical Chairs and  have been able to drop their service from the overall University contract.

 Dr. Frohman expressed his excitement for the Clinical Services Initiative.  He  said each Medical Director must be committed to make their clinic the best.  He   also felt staff needed to be incentivized.

VII. Conclusion

 Dr. Rutherford confirmed that there was broad agreement with Committee  members for a standardized job description.  Other necessary considerations for  the Medical Director position include:

• Empowerment by the Chair to act with authority in operational decisions for the clinic.
• Provide Medical Director with the time and tools necessary to conduct the responsibilities of the position.
• Consider Medical Directors’ responsibilities for promotions and tenure.
• Provide appropriate salary and incentives

 Dr. Rutherford will discuss this and with the Executive Committee of the Clinical  Chairs and with the Clinical Chairs.