Medical director, an evolving and expanding role of the physician-executive.

The evolution of the role of medical director is an ongoing process. This paper examines several questions as to the origin, purpose, and practice of physicians in the role of a physician executive. The sense that management practice and medical practice may require different skills is noted. As the field of medicine is faced with increasing turmoil in efforts to balance the cost of health care with the quality of health care, such physician executives may be in the best position to have critical input into strategic decisions bearing upon the delivery of health care. The reasoning behind this notion is that a medical director will have experience in the actual practice of medicine, thus knowing what it is like to be "on the firing line" of providing medical care while at the same time will have appreciation of the business side of medicine related to the issues of economics and, allocation of resources and finance, among other critical management skills. Whether utilizing administrative and management skills in a hospital, group practice, HMO, or industry, the medical director of the present and future will have an increasingly important role in speaking the languages of medicine and business and interfacing between the two disciplines.