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    The Role of the Executive Director

    Before the creation of the Palo Alto Medical Foundation, the Clinic's executive director oversaw everything from contracting to clinical issues. After Foundation leaders took over most business operations, the executive director continued to exist as head of the physician group.

    "One of the executive director's main roles is to bridge the gap between the Clinic and the Foundation, two legally distinct organizations," said George Perlstein, a neurologist who served as executive director from 1995 to 2000. "I was the face of the physician group to the Foundation board of trustees, and the face of the Foundation to the physician group."

    The executive director, supported by the Executive Board and department leaders, also oversees all physician management issues, such as compensation and clinical decisions – "delivering happy and not-so-happy messages to the doctors and managing the business side of the practice," Dr. Perlstein said.

    Before becoming executive director, Dr. Perlstein served as medical director, a position created in 1990 when leaders decided the group had become too large for the executive director to manage alone. The medical director held responsibilities such as deciding when new physicians were needed and disciplining doctors if necessary. Even this job, however, was "too big for one person," so the Clinic instead split the responsibilities between multiple division heads, who now oversee primary care, surgical specialties, ancillary departments and the Fremont Center.

    Like his predecessors, Dr. Perlstein found "herding" the physician partnership to be one of his more difficult responsibilities as executive director. "Communicating to everyone the need for all of us to pull in the same direction, to march to the same drummer, was a challenge," he said. Nevertheless, "my favorite part of the job was coming to work in the morning. I loved it. This group of doctors is extraordinary, the patients are fantastic, and the support from the community and the Foundation board of trustees is beyond imagination. It's a great place, and a great place to lead."

    In 2001, the executive director's title was changed to chair of the Executive Board. The chair is elected by the physician partnership to a five-year term. Following Dr. Perlstein, the position was held by Dr. Francis A. Marzoni, who now serves as president of the Foundation's Palo Alto Division. The Clinic's current Executive Board chair is internist Terrigal Burn.

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