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Tip of the week: Take a proactive approach to low-volume providers

Medical Staff Leader Connection, July 29, 2010

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Regardless of their reasons for not being active at the hospital, many low-volume practitioners want to maintain medical staff membership because their managed care plans require them to be affiliated with a hospital.  Although the National Committee for Quality Assurance no longer requires this, many managed care plans still do, says Christina Giles, CPMSM, MS, president of Medical Staff Solutions, a consulting firm in Nashua, NH.

“If someone is low-volume or no-volume, the first thing the medical staff should do is have a leader talk to the practitioner in person and ask ‘What is your need for the hospital?’” she says.

The goal is to work with the physician to whittle down the number and types of privileges that he or she holds . In the best-case scenario, the physician understands that the hospital must assess practitioner competency to meet accreditation standards and voluntarily relinquish some privileges.

The worst-case scenario is that the physician refuses to give up some privileges, and the medical staff is forced to revoke those privileges because the physician does not meet the medical staff’s competency criteria. Revoking a practitioner’s privileges based on his or her inability to meet the medical staff’s criteria will not trigger a fair hearing is not reportable to the National Practitioner Data Bank because the revocation is due to the physician’s failure to comply with requirements rather than an adverse action.

This week’s tip is from “OPPE for low-volume practitioners: Process, tools, and strategies for getting the performance data you need,” in the August issue of Medical Staff Briefing. 

 

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