Motivated, Engaged Physician Leaders Bring Higher Value to Post-Acute and Long-Term Care Settings

December 3, 2019

In Engaging Physician Leaders for Higher Value, an article in the December issue of JAMDA, the authors discuss how medical director engagement is below par in the post-acute and long-term care (PALTC) setting and offered strategies for enhancing internal motivation and engagement for these physician leaders.

In 1974, federal regulations first required skilled nursing facilities (SNFs) to have medical directors. Subsequently, AMDA – The Society for PALTC Medicine provided in-depth guidance on the expectations of the medical director role. Years later, SNF medical directors’ impact continues to be inconsistent, the authors stated. “This is not due to lack of effort from AMDA… the Society has done its part in defining the job description and making available many tools to operationalize the role successfully.” However, fewer than 25% of all SNF medical directors are AMDA members and even fewer have completed AMDA-sponsored medical director training and certification.

Based on the authors’ experience, they suggested some key recommendations to help promote a culture of higher medical director and practitioner engagement for better outcomes:

  • It is critical that health care leaders invest in internal frameworks for motivation to promote engagement.
  • AMDA and other clinician societies should collaborate with industry partners to create practical and agile tools for medical director and team training.
  • AMDA should promote the use of technology to operationalize its guidelines, as well as implement meaningful and timely performance dashboards and other tools that can help with fairness, mastery, autonomy, and purpose (FMAP) strategies.
  • AMDA should continue to collaborate with other stakeholders to implement more meaningful, timely, and relevant quality measures and financial incentives.
  • Academic researchers, behavioral economists, federal survey agencies, frontline clinical team members, consumers, and other stakeholders should work together to brainstorm upgrades in the accountability structure.
  • SNF leadership should set up formal systems to more fully engage medical directors who demonstrate a genuine passion for PALTC.

“A more holistic and multi-dimensional approach is needed, if we are to succeed in driving transformative engagement and inspiration of front-line physicians,” the authors observed.

This study was conducted by researchers at the Division of Family Medicine and Geriatrics, University of Louisville, Louisville, KY; Signature HealthCARE, Louisville, KY; The Evangelical Lutheran Good Samaritan Society, Sioux Falls, SD; and Genesis Physician Services, Kennett Square, PA.

Click here for more information on the findings above and more details about the study. To contact the researchers or JAMDA editor for an interview, please email



JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit for more information.

About the Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information.