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Greeley bylaws and governance monthly: Has the responsibility of medical staff leadership become too burdensome?

Medical Staff Leader Connection, June 10, 2009

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With physicians working longer hours and also devoting more time for family, they don’t have a lot of time left over for voluntary medical staff activities. We physicians value our time—we are willing to spend some on organized medical staff activities but it better be put to good use. 

Some may not realize it, but The Joint Commission mandates only one committee—the medical executive committee. The Centers for Medicare and Medicaid Services does not require any. In the past, The Joint Commission stated that the medical staff needed to be involved in and/or oversee various functions, such as infection control, pharmacy and therapeutics, and others. Many medical staffs interpreted that to mean that they needed to form a committee to serve each function, so a dedicated few went to multiple meetings and heard the same information repeatedly. This is not good use of a physician’s time.

Consider whether some of these medical staff committees could function as multi-disciplinary hospital committees or whether some of the functions could be consolidated into fewer committees that are run more efficiently. Could some committees even be eliminated? Some medical staffs may hesitate to eliminate a committee for fear that its services will be needed down the road, but remember that you can always assemble ad hoc committees when a need arises.

Many medical staffs feel they function well with only three committees: the MEC, a credentials committee, and a centralized peer review committee. This allows those few dedicated physicians to do valuable work efficiently. It also enables the hospital and/or the organized medical staff to train and potentially compensate these dedicated individuals that do the work of the entire medical staff.

This doesn’t mean that physicians would not be involved in committees such as pharmacy and therapeutics and infection control, but fewer total physicians would need to be dedicated to these activities, and the burden of organizing and running these committees would not longer be on the medical staff’s shoulders.

Physicians need to be involved, so let’s ensure that the time they dedicate to the medical staff is spent on productive activities.

Next time, we’ll talk about another way to improve medical staff efficiency—changing from departments to services.

Mary Hoppa, MD, MBA, CMSL, is a senior consultant with The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.

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