Between physicians and payers: Physician executive in dual role seeks to build trust

Paul Handel, MD, has enjoyed a long, distinguished career as a physician in Texas, and now he wears two distinctive hats-neither of which is a Stetson.

"I don't know of any other state association that has a doctor on its board who's also an officer of a carrier," he says. "I also don't know of a carrier anywhere in the country that has an officer who's also on the board of a state association. I do know that the past couple of years with the TMA and BCBSTX have been the most rewarding and exciting of my career."

A board-certified urologist, Dr. Handel ran a successful private practice in Houston and was a clinical professor of surgery at the University of Texas Health Science Center Medical School. A graduate of the University of Texas Medical Branch in Galveston, Dr. Handel's career has earned him recognition on both state and national levels.

Q. As a board member of the TMA and chief medical officer of BCBSTX, you have a unique perspective on both the provider and payer sides of the fence. How would you characterize today's relationship between payer and provider?

At BCBSTX, we're including physicians in the creation of policies and procedures-that's key. For example, as we begin to look at pay-for performance and other evaluation measurements, we begin to see the real picture of what physicians are all about, and we're working with them to help us develop the metrics by which they'll be measured and evaluated-and that goes for the inclusion of patients, too. Believe it or not, this kind of inclusion has only recently begun happening in the healthcare industry.

Medicine has evolved to a point of a lot more communication and education of this kind. We're truly at the beginning of the process-and a lot more communication and education is needed.

Q. Along those same lines, how thin a wire do you walk in advocating for providers as a TMA board member and for payers in your role with BSBSTX? What are the advantages of being on both sides of the table? The disadvantages?

A. Not long ago I met with a physicians group, and one of them asked me what my position was with BCBSTX. I kiddingly-maybe half-kiddingly-replied that I'm the piñata-I take the knocks on both sides. I've been accused of taking the TMA position by BCBSTX and the BCBSTX position by TMA.