title: The evolving role of the medical director of a dialysis facility.
abstract: The medical director has been a part of the fabric of Medicare's ESRD program since entitlement was extended under Section 299I of Public Law 92-603, passed on October 30, 1972, and implemented with the Conditions for Coverage that set out rules for administration and oversight of the care provided in the dialysis facility. The role of the medical director has progressively increased over time to effectively extend to the physicians serving in this role both the responsibility and accountability for the performance and reliability related to the care provided in the dialysis facility. This commentary provides context to the nature and expected competencies and behaviors of these medical director roles that remain central to the delivery of high-quality, safe, and efficient delivery of RRT, which has become much more intensive as the dialysis industry has matured.
authors.affiliation: Fresenius Medical Care North America, Waltham, Massachusetts; and frank.maddux@fmc-na.com.
authors.forename: Franklin W
authors.initials: FW
authors.lastname: Maddux
authors.affiliation: DaVita HealthCare Partners, Denver, Colorado.
authors.forename: Allen R
authors.initials: AR
authors.lastname: Nissenson
mesh_terms: D002983:Clinical Competence; D019033:Delivery of Health Care, Integrated / Q000266:history / Q000592:standards / Q000639:trends*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000266:history / Q000628:therapy*; D007857:Leadership; D006278:Medicare; D009398:Nephrology / Q000266:history / Q000592:standards / Q000639:trends*; D008486:Physician Executives / Q000266:history / Q000592:standards / Q000639:trends*; D010819:Physician's Role / Q000266:history; D011787:Quality of Health Care / Q000266:history / Q000592:standards / Q000639:trends*; D014481:United States; D000078329:Workforce
keywords: ESRD; chronic dialysis; nephrology