Physicians considering alternative non-clinical careers are now looking at the position of a physician advisor.
Dr. Elizabeth Varghese-Kroll will be speaking on this topic at the SEAK Non-Clinical Careers for Physicians Conference on October 22-23, 2016 in Chicago, IL.
Dr. Varghese-Kroll was recently interviewed on what it means to be a physician advisor.
Q: Dr. Varghese-Kroll, what is a “physician advisor” and what role do they play?
A: physician advisor is a liaison between a hospital’s clinical physicians and its Utilization Review team. A physician advisor helps the medical staff achieve medical necessity compliance and improve documentation, while also helping the UR team understand the physician’s perspective on each case and assisting them in drafting recommendations and appeals. The physician advisor may also serve as a point of contact for payors, formulating and discussing appeals with them. In addition, physician advisors provide education on documentation requirements and policy changes to both physician and non-physician staff. On-site, a physician advisor may round with various teams. Off-site, a physician advisor may discuss cases by phone or electronically. It’s important to remember that, while a physician advisor uses their clinical skills every day, they are not directly responsible for patient care, and thus are not giving diagnostic or treatment recommendations. A good physician advisor needs to be a great clinician, an excellent communicator, and have strong interpersonal skills in order to be able to work with and educate other physicians. In essence, a physician advisor takes a major responsibility off the plate of their physician peers, while ensuring that that critical role is filled for the hospital.
Q: Can this work be done part-time, and if so, how does that work?
A: In many cases, yes. Those who work off-site may be able to simply take available cases during their scheduled hours. For physician advisors that work on-site in a hospital, many smaller facilities don’t need someone on the premises full-time, so you can negotiate to be present a certain number of hours a week or on particular days, and the hospital will save cases for when you are available. In larger facilities, job-sharing with another part-time physician advisor may also be possible.
Q: How do physician advisors make a difference in the lives of patients and the general public?
A: We often hear that the face of healthcare is changing at lightning-speed (and it is – a decade or two ago, physician advisors didn’t exist), and what that really means is that governmental and commercial payors are increasingly scrutinizing every claim they receive for medical necessity. When physician advisors can help improve compliance and documentation, they are improving quality of care. Lengths of stay are optimized and medical errors are decreased. That directly impacts patients, and patients can see it. When physician advisors prevent inaccurate reimbursements, or help correct inaccurate reimbursements that have already occurred, they are ensuring that resources remain available and that the hospital will be around to care for its patients for years to come.
Q: What one piece of advice would you give to physicians who want to break into the physician advisor field?
A: Read everything you can. Not just about the field of physician advising, because it’s always changing, but also about medicine in general. Go back to your med school roots and reread about the specialties and diagnoses you may not have had a chance to see since then. It is extremely rare for a client to require physician advising only in your specialty. In the vast majority of cases, they will need help with everything, from pediatrics, to OB-GYN, to psychiatry, to surgery, to beyond. Therefore, the more you know about fields other than your own, the more helpful an advisor you can be, and the better recommendations you can give.
Elizabeth (Lisa) Varghese-Kroll, MD has been a home based Physician Advisor with Executive Health Resources since 2012. She has experience in both EHR’s concurrent and appeals divisions. Dr. Varghese-Kroll is board certified in physical medicine and rehabilitation. She received her BS in Mass Communications from Virginia Commonwealth University, summa cum laude and her MD from the University of Virginia. Her journalistic experience includes an internship at CNN working for Dr. Sanjay Gupta as well as work for the Judiciary Committee of the U.S. House of Representatives. Dr. Varghese-Kroll is a SEAK alumnus.