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The Medical director of VITAS fulfills two primary functions, each of which is expected to consume approximately one half of the time and work effort of the position:

• The Medical director has overall responsibility for medical direction of the care and treatment of patients and their families rendered by the hospice care team, and shall consult and cooperate with the patient's attending physician. The medical director provides physician direction and guidance to the hospice program, its physician employees, and other staff and volunteers to assure the maintenance of quality standards of care for patients and families.
• The Medical director educates practicing physicians and others engaged in health care services regarding the hospice program and its potential benefits to patients.

In fulfilling the two primary functions explained above, the Medical director performs the following duties:

• Quality of Clinical Care
  • Assure appropriate evaluation and certification of terminal prognosis of patients.
  • Assure the quality of initial plans of care.
  • Assure the quality of comprehensive plans of care.
  • Assure the accuracy of documentation.
  • Review revocations.
  • Review recertifications of terminal prognosis.
  • Review the quality of pain and symptom management.
  • Provide medical expertise on pain and symptom management to admission and patient care staff.
  • Provide medical expertise on the evaluation of terminal prognosis to admission and patient care staff.
  • Actively participate in formal QI functions and committees.
  • Actively participate in Interdisciplinary Group.
  • Actively participate in Ethics Committee.
  • Interact with attending physicians as necessary regarding pain and symptom manage ment issues and issues involving patient prognosis
  • Periodically attend home care team meetings and rounds in inpatient units.

• Supervision of team physicians (home care and inpatient)
  • Interview and participate in the hiring and contracting of team physicians with the general manager, patient care administrator and/or team manager.
  • Orient team physicians as to clinical responsibilities and the principles of palliative medicine.
  • Periodically review the quality of clinical care provided by the team physician.
  • Periodically review the quality of the quality of the documentation of visits made by the team physician.
  • Assure that documentation of visits supports the CPT coded level of service billed.
  • Ensure proper team physician participation and support in team meetings.
  • Ensure proper team physician support to the VITAS nurse, team manager, and other clinical team members.
  • Participate with the team manager in the yearly formal evaluation of the team physician.
  • Ensure that a physician on-call rotation is established so that there is team physician support available 24 hours a day, 7 days a week.

• Management
  • Participate as an active member of the local/regional management team (includes budget process, strategic planning, etc.)
  • Actively participate in responding to audits and denials from third party insurance and intermediaries (i.e. Medicare)
  • Ensure that all contracted physicians (team physicians and consulting physicians) are properly credentialed via the VITAS Credentialing process.
  • Serve on the VITAS Credentialing Committee.
  • In Wisconsin the medical director also supervises the following functions of the consultant pharmacist:
    • Ensure medications are utilized within accepted standards of practice.
    • Ensure a system is developed and maintained that documents the disposal of controlled drugs.

• Community Relations
  • Educate community physicians on the principles of palliative medicine.
  • Provide resource and consultative support to community physicians in palliative medicine.
  • Attend and present at medical staff and other medical community conferences on palliative medicine.
  • Serve as liaison between the hospice and community physicians.
  • Make regular contacts with practicing physicians to introduce the hospice program, to educate physicians regarding individuals for whom hospice may be appropriate, and to answer clinical and other concerns of physicians with respect to hospice.
  • Assist in introducing the VITAS program to long term care providers, managed care providers, hospitals, and others.
  • Conduct educational seminars, in services, and presentations to physicians, nurses, and other health care audiences whose support for and understanding of the hospice program is integral to assuring that hospice services are made accessible to patients and families.

• Education and Research
  
  • Assist in the development of and actively participate in clinical training for all hospice patient care and admissions personnel.
  • Actively participate in medical and nursing education programs on palliative medicine that may be provided by VITAS to medical and nursing colleges in the community.
  • Assist in the development of and actively participate in research protocols on both the local and corporate level.
  • Be a member of and participate in professional organizations related to palliative medicine.

• Knowledge of the principles and practice of primary medical care, with at least a working knowledge of oncology.
• Knowledge of palliative care with particular emphasis on control of symptoms associated with terminal illness.
• Ability to work collaboratively with patients' attending physicians to implement the hospice program and effect optimum medical care.
• Ability to work collaboratively with hospice employees and volunteers as part of an interdisciplinary team.
• Membership in good standing on the medical staff of an accredited hospital in the state in which the hospice is located.
• Medical malpractice and liability insurance in amounts and with carriers satisfactory to VITAS.
• Positive recommendation to the general manager or area vice president from corporate medical officer.

• License to practice medicine in the state in which the program is operating.
• Board certification in a medical specialty which deals with care of the terminally ill, such as Internal Medicine, Oncology or Family Practice, with at least a working knowledge of medical oncology and demonstrated expertise in the principles of palliative medicine and symptom management.