Years ago, many small and medium-sized physician groups struggled as they grew to determine if and when they needed a managing doctor, medical director, or physician-leader position. Today, the question is more likely, "How do we best utilize our leader and how do we structure our practice's leadership?"
Imagine a large corporation with no CEO but a dozen shareholders with equal say, or a large company with satellite offices but no "boss" running the show at each site. Many practices still run this way. Although practices of all types and sizes recognize the need for leadership, they still struggle with how to structure their top positions and how to best govern their practice from a business standpoint.
Practices can structure themselves much like the managed care companies they contract with for business. For example, a large primary care practice can hire a medical director to help guide member-physicians through difficult decisions they would have previously ducked.