The medical director of a hospital sleep laboratory told me of this incident that reflects the physician position in the health care team.
The HMO operations office had an appointment with the hospital administrator to work out the agreement for doing polysomnograms for Obstructive Sleep Apnea and the reimbursement plan. The hospital administrator was new at his job and invited the medical director of the sleep lab to the meeting. The HMO administrator seemed upset with his presence. The meeting was rather short and the doctor left.
Later the hospital administrator told the medical director that the HMO felt they should have been able to work out the details of payment and supervision between administrators without the intrusion of a physician.
The feeling seems to be that medical directors are only a legal requirement, not one with any important medical or supervisory responsibilities. They are present in name and title like the equipment but should not interfere with any medical operational activity.
Physicians must remember that patients hold us accountable for anything that occurs in the hospital. We had best make our presence felt.