HR and the Hippocratic Oath: The VP of HR Will See You Now

By Mike Payne

Jun. 30, 2017

HR leaders today are faced with unbounded complexity and overwhelming options when it comes to managing the well-being as well as the health and benefits spend of their populations. Choices about health plan benefit design, life-saving specialty medicines, expert-opinion services, proportion of medical spend borne by employees out of pocket and innumerable other decisions can weigh heavily on the mind of even the most objective HR lead.

As a result, HR departments often need professional help in navigating their choices, especially from a clinical point of view. Often, benefits consultants and health insurance carriers position themselves to provide such expertise and advice, and hire and deploy clinical leaders to do so — but their advice should not be taken in a vacuum.

No surprise here, but consultants and carriers are paid to give advice. The best of these people are often excellent advocates for their HR customers and the employee populations they represent.

However, benefit-consultant and health insurance carrier representatives can receive financial incentives to promote certain products or services over others. Not unlike the Arthur Andersen accounting-consulting debacle of the 1990s or the Wall Street equity research-investment banking scandals of the 2000s, benefits consultants and health plans are in the precarious position of claiming to provide objective advice on products that they, themselves, have a financial stake in.

This would be less problematic if the products being promoted were simple health-savings accounts or flu shot programs. However, many of the decisions that HR practitioners seek counsel on are quite complex from a clinical or health care business perspective (consider the choice of one hepatitis C medication over another or narrow vs. broader-network health plan products).

Given this complexity, who should HR leads turn to for unbiased, expert opinions?

The Doctor Is In-House

Optimally, an HR pro would have a business-savvy physician with aligned incentives throughout the benefits decision-making process. Receiving the advice of — or even directly hiring physician leaders in the HR suite is challenging, but entirely doable.

Often in large companies, physicians are on the payroll, but not necessarily working in the HR group. Instead, they may work in a business unit focused on health care or in an occupational health and safety group. There are natural synergies between OHS and HR, not the least of which is to leverage health care expertise across both groups. As such, HR leads should seek out their in-house occupational and environmental medicine physician. They could become helpful advisers, official collaborators or even employees.

Alternatively, HR leaders could convince their leadership that hiring a physician-administrator is an important part of a good health and benefits strategy.

HR leaders are asked to make increasingly complex health care decisions on behalf of their populations. The lines between health-related administration for employers, plans and providers are blurring. This places an increasing onus on employers to up their game as savvy health care decision-makers. In some ways, the health and benefits portion of HR’s responsibility is its own specialty, akin to hospital and health plan management, which are often carried out and always advised by physicians.

HR leaders embracing this new responsibility do so seriously and with pride, just as medical school graduates pledge to do no harm. They will seek out unbiased sources of medical and business advice and balance the advice of external benefits consultants and health plans with internal expertise, often in the form of physician employees. They will seek out experts from within their own firms and the market at large.

All to do right by their companies and perhaps more importantly, the employees and dependents who are now effectively their patients.

Mike Payne is head of commercial and policy at Virta Health, an online specialty medical clinic. Comment below or email

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