Credentialing & Privileging

Readers' responses to 'ending the charade'

Credentialing Resource Center Connection, August 1, 2003

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Dear Credentialing Colleague:

The July 18 edition of Credentialing Connection, titled "End the Charade: Make the MEC your board's subcommittee," generated quite a few responses from readers. Many of you submitted follow-up questions and comments regarding this issue. This week, I'd like to share some of the more frequent questions/comments and my responses to them.

FROM A PHYSICIAN/ATTORNEY: While I believe in cutting red tape whenever possible, I have a problem with the suggestion that the medical executive committee (MEC) should become a subcommittee of the board. The rationale for this move is what fuels escalating fights between hospitals and medical staffs. The MEC and board were designed to be and should remain separate entities with separate bylaws. One should not be the arm of the other.

RESPONSE: In my experience, hospitals that made their chief executive officer, medical staff president, and one other MEC member a subcommittee of the board have had no problems. I believe if we continue to foster "separateness" between the MEC and the board, we will simply increase the conflict. Trusting the board subcommittee to make important decisions on behalf of the board demonstrates an "us" mentality instead of an "us versus them" mentality. I feel that hospitals should consider the option I described on July 18 now that it is available to them.

FROM AN MSSP IN FLORIDA: A JCAHO representative told me that even if a governing board members serve on a hospital's MEC, the board still needs to ratify the recommendations of the subcommittee.

RESPONSE: You are correct, the governing board needs to receive the minutes of all committees. Therefore, it would receive the board subcommittee's minutes just as it would receive the finance committee's minutes. This is routine and should not cause any problems.

FROM AN MSSP IN WISCONSIN: Hospitals should check their state laws regarding special committees of the governing board. In the state of Wisconsin, law specifically permits the board of directors of a non-stock corporation to designate one or more committees to carry out various functions, if so provided by the articles of incorporation or bylaws. It also requires such committees to consist of three or more directors elected by the board. Therefore, in Wisconsin, we are required to have three voting members on the board subcommittee as opposed to the two required by the JCAHO.

RESPONSE: This is very useful information! Thank you for sharing and reminding us to always check state law.

That's all for this week.

All the best,

Hugh Greeley



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