Hiring the right medical director who will actually protect your clinic when a state board comes knocking is not easy. Most facilities rush this decision by signing the first willing MD they find, maybe through a conference contact, a friend, or a cheap online service. But when something goes wrong due to a patient complaint, an audit, or a botched treatment, the director who promised protection is nowhere to be found. Here is what to look for in a medical director other than just their license.
A License Says Nothing About Engagement
Hiring a medical director who signs paperwork and then disappears creates a legal liability. State medical boards have now started looking closely at these setups. If a medical director supervises several states across different states but cannot answer a simple question about any of them, it’s a red flag and puts everyone on the paperwork at risk.
Scope of Practice Knowledge
A cardiologist may have a valid license but still be the wrong fit for a medical spa. Other areas like hormone therapy, IV drip work, medical weight loss, aesthetic medicine, etc, sit in their own regulatory corners. A medical director without real experience in the services you offer may sign protocols that don’t match the work your staff actually does on the floor.
So make sure you ask about their background in your modalities. If you handle neurotoxins and fillers, ask when they last reviewed a complication case, or if you run GLP-1 weight loss programs, ask what telehealth platforms they have worked with. Value answers are a red flag.
Writing Protocols and Standing Orders
Some directors who only want a retainer will not write standing orders and will not sign off on new treatments you may want to add, and may not sit for a deposition. You should know that a medical director who avoids writing anything in their own hand is not doing the job. If the board asks who authorized the treatment, you will need a paper trail with real clinical reasoning behind it. They will draft procedures and update them when rules change, and also put their name behind decisions.
What Happens During an Incident
In case of emergencies, your nurse injector will call the director, and what happens next matters more than paper credentials. So make sure you ask the potential director for their response protocol for adverse events by asking them how many hours per week they set aside for your practice and what happens if they go on vacation. If the answer seems scripted, move on to the next.
Scope of Oversight Across State Lines
A medical director who works well in one state may not understand the rules and restrictions in another state. If your medical facility operates in several different states, you need a director or a network of directors who know the differences among the different states.
Corporate Practice of Medicine laws vary by state. In some states, physicians can own any entity that provides medical services, while others allow an MSO-PC structure where a management company supports a physician-owned professional corporation. The director you hire should understand which model you need and how to stay inside it. Hiring a single medical director for a national telehealth brand and then finding out that the arrangement violates state statutes can be a hassle.
Insurance and Documentation
Make sure the director carries their own malpractice coverage for supervision work and ask to see a certificate of insurance. Also, confirm what the fee covers and what triggers extra charges. It is important that you make a clear written agreement putting the duties in writing, and also mentioning the response times. Also, write down exactly how either side can end the relationship. Flat monthly retainers have no scope attached, as these contracts often hide the fact that the director is not really engaged with your clinic.
Red Flags to Watch For
Here are some recurring patterns in bad deals:
- The physician will not be able to discuss the clinic’s services during the initial phone call.
- The physician will not sign any orders or protocols for the patients.
- The physician asks that you prepare the contract, and they will sign the document without reading it.
- They oversee more than fifty clinics that aren’t even related to yours in different states.
- They don’t have their own supervising liability insurance.
- They can’t describe how CPOM works in your state.
Just one of those is a red flag; two or more, definitely time to move on.
A Better Way to Hire
Proper medical direction involves both clinical leadership and risk management, and it even comes with operator backup where necessary. However, finding one such qualified individual to fill these roles within your state, at a reasonable rate, can be difficult. For this reason, it has become common practice for clinics to use networks to select and assign directors based on their specific treatments.
A license lets your director enter the door; everything else keeps it open.
