Credentialing & Privileging

How to run an efficient fair hearing

Credentialing Resource Center Connection, February 27, 2003

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Dear Credentialing Colleague:

A couple of weeks ago, I suggested that hospitals should offer fair hearings only when the medical executive committee (MEC) takes or recommends action that would directly and substantially affect a physician's ability to practice independently. This week, I would like to suggest a few commonsense approaches to running an efficient fair hearing if and when one is needed.

First, hold a pre-meeting conference where the involved parties can establish ground rules, exchange documents, agree on the anticipated length of the hearing, and order a list of witnesses.

Second, select a very experienced hearing officer or chair. There is no substitute for experience. If your institution does not have an individual with experience in the fair hearing process, don't hesitate to secure a seasoned hearing officer from outside the facility. This individual could be a physician, lawyer, or other professional with a significant medical staff and fair hearing background.

Regardless of the mechanism used to select your hearing officer, your institution should provide "just in time" training for this individual. The officer must understand that he or she has the ability to limit lengthy presentations, control the number of witnesses called, and dictate the method of cross-examination. A hearing officer also has the ability to ensure that attorneys do not play an inappropriate role in the process.

Third, move the hearing along efficiently. Any institution anticipating a hearing should secure the services of an experienced health care attorney to assist in orchestrating the proceedings. This individual need not--and in some instances, should not--be the hearing officer or the attorney advising the hospital or MEC on the particulars of the hearing. He or she should be able to "observe" the hearing from afar and provide strategic direction to management and the MEC.

Times have changed, and institutions can't avoid the presence of lawyers in the hearing room anymore. Under the Health Care Quality Improvement Act, any physician who requests a hearing has the right to legal counsel at his or her expense. Attorneys should not, however, be permitted to monopolize hearing discussions.

Following the three above-listed steps should allow you to avoid a complex hearing. Remember, the fair hearing was originally designed to be a relatively collegial process between physicians and the hospital, not an adversarial legal proceeding.

That's all for this week.

All the best,

Hugh Greeley
www.greeley.com/seminars/



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