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Role and Value of the Corporate Medical Director ACOEM GUIDANCE STATEMENT Role and Value of the Corporate Medical Director J. Brent Pawlecki, MD, MMM, Wayne N. Burton, MD, Cherryl Christensen, DO, MS, K. Andrew Crighton, MD, Richard Heron, MB, ChB, FRCP, T. Warner Hudson, MD, Pamela A. Hymel, MD, MPH, and David Roomes, FFOM, FACOEM, ACOEM Corporate Medical Directors Section Task Force accreditation in occupational medicine or the more preferred double The role of the corporate medical director (CMD) has evolved over the last certification in occupational medicine, and another board such as 300 years since Ramazzini first identified diseases of Italian workers in the 01/04/2019 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3VFjldD2uL9p7SMbj5XQFggscApMlmW/UgXNoK/5MD7Gq31Q2YQqh0A== by https://journals.lww.com/joem from Downloaded Downloaded internal medicine or family medicine. Further qualifications such as a early 1700s. Since then, there has been a gradual blurring of the boundaries master of public health or masters-level degree in environmental between private and workplace health concerns. Today’s CMD must have health, business administration, or law are highly desirable, including from intimate knowledge of their corporation’s industry and the businesses that knowledge of epidemiology, biostatistics, population health manage- https://journals.lww.com/joem they support, particularly the occupational and environmental programs that ment, business management, and regulatory aspects of employee comply with all local, state, and/or national standards and regulations. health. CMDs should also remain active in their relevant professional Leading companies not only measure compliance with such standards but health organizations to demonstrate that they are remaining current in also may hold programs to their own internal corporate global standards even medicine. Before taking on the role of CMD, it is advantageous to if these go beyond local government requirements. This document will have at least 10 or more years of practical experience as an occupa- explore in greater depth the strength and importance that the CMD brings to by tional health physician, preferably within a global setting, including at BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3VFjldD2uL9p7SMbj5XQFggscApMlmW/UgXNoK/5MD7Gq31Q2YQqh0A== the business operations to support a healthy, engaged, and high performing least 5 years in a leadership role managing physicians and other workforce. Part 1 describes the role and value of the CMD, while Part 2 licensed health care professionals. provides collective wisdom for the new CMD from current and past highly The role of the CMD has evolved over the last 300 years from experienced CMDs. Ramazzini’s identification and prevention of the diseases of Italian workers in the early 1700s.1 Since then, there has been a gradual he corporate medical director (CMD), also known as the chief blurring of the boundaries between private and workplace health T medical officer or chief health officer, typically has overall concerns,2 to today’s focus on health management for enhanced medical responsibility for the company, including all issues related business performance, health care cost containment, and health- to health (emergency response, critical event management, medical related productivity loss mitigation.3 As the business partnership leaves, occupational and environmental health programs, commu- expectations for medical directors have increased, so has the need to nity health interface, and leadership and management of the medical identify the best global providers of care who are able to rapidly organization). Frequently, the scope of the role extends to include identify evidence-based interventions for employee populations, as responsibilities within related disciplines such as product steward- well as oversee legal regulations, product stewardship, research ship (toxicology) in partnership with research and development, facilities, and the health of all employees. Finally, the CMD serves global security (proactive disaster planning), industrial hygiene as subject matter expert (SME) for any health-related issues that are and safety (biologic monitoring, protective equipment), human faced by the employees and their families as well as by the resources (HR), and health care benefits design. The company corporation and the communities in which they operate. may also look to the CMD to design and implement a global Today’s CMDs must have intimate knowledge of their cor- health and well-being strategy working closely with HR, finance, poration’s industry and the businesses they support, particularly the and company leadership, to provide a population health perspective occupational and environmental programs that comply with all for the corporation. local, state, and/or national standards and regulations. Leading In most developed countries, including the US, broad health companies not only measure compliance with such standards but and management experience is highly useful before taking on the role also may hold programs to their own internal corporate global of CMD. Ideally, the candidate should hold an unrestricted license to standards even if these go beyond local government requirements.4 practice medicine in her or his home headquarters country, although Audits may be conducted to assure compliance with legal and that may not be a requirement in every organization or country. He or regulatory requirements as well as company standards and the she should also achieve board certification, a recognized specialist results may be reported periodically to senior leadership and other appropriate external stakeholders to keep them informed about on potential vulnerabilities. 01/04/2019 From the American College of Occupational and Environmental Medicine, Elk Grove, Illinois. This document explores in greater depth the strength and This position paper was developed by the ACOEM Corporate Medical Directors importance the CMD brings to the business operations to support a Section Task Force, reviewed by the ACOEM Committee on Policy, healthy, engaged, and high-performing workforce. Part 1 describes the Procedures, and Public Positions, and approved by the ACOEM Board of role and value of the CMD, while Part 2 provides collective wisdom for Directors. ACOEM requires all substantive contributors to its documents to disclose any potential competing interests, which are carefully considered. the new CMD from current and past highly experienced CMDs. ACOEM emphasizes that the judgments expressed herein represent the best available evidence at the time of publication and shall be considered the position of ACOEM and not the individual opinions of contributing authors. PART 1: THE ROLE AND VALUE OF THE The authors declare no conflicts of interest. CORPORATE MEDICAL DIRECTOR Address correspondence to: Marianne Dreger, MA, ACOEM, 25 Northwest Point Blvd, Suite 700, Elk Grove Village, IL 60007 ([email protected]). HEALTH POLICY, STRATEGY, AND LEADERSHIP Copyright ß 2018 American College of Occupational and Environmental Medicine The CMD has a major opportunity within the corporate DOI: 10.1097/JOM.0000000000001326 environment to demonstrate the value of a well-developed health JOEM Volume 60, Number 5, May 2018 e215 Copyright © 2018 American College of Occupational and Environmental Medicine. Unauthorized reproduction of this article is prohibited Pawlecki et al JOEM Volume 60, Number 5, May 2018 policy, a well-executed strategy, and better business outcomes. First, individual stand-alone programs by themselves can do little to the CMD must understand the corporate mission and its core address the health risks in a population. On the contrary, a compre- business including products and/or services. Next, an in-depth hensive approach, including efforts to create a healthy culture with a understanding of how the corporate medical department specifically supportive environment and ongoing strategically designed pro- supports the business plan is essential. What does success look like grams that are refreshed and updated, has been shown to be in this organization? What are the health and well-being resources beneficial for employee health and also for businesses.12–14 A currently in place, and are they delivering against expectations? The healthy culture enables employers to reduce their health care cost CMD should determine and clearly articulate a vision of optimal trends and support a high energy, engaged, productive workforce.15 health and business success while efficiently using resources to A comprehensive well-being program requires a broadly deliver on this vision. The CMD should be able to engage leadership integrated team approach usually including the CMD, HR, benefits, in this business case, which includes outlining risks of delayed or safety, public affairs and communications, legal, finance, and other failed implementation in order to ensure well-informed decisions stakeholders. Central to the success of a well-being program is are made. leadership alignment and visible support from both senior and Using a variety of data sources – such as HR, health middle management as well as worker representative groups such promotion, health and safety, security, medical leaves (eg, workers’ as trade unions. While the goal may be a global program with compensation, disability, etc) and potential occupational exposures consistent branding, key messages, and measures, it is critical to – the CMD identifies the health risks of the workforce as well as the
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