Medical Staff

An offer they can't refuse

Medical Staff Leader Connection, January 10, 2004

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Dear Medical Staff Leader:

Imagine this scenario: A medical executive committee (MEC) decides that it must speak directly to Dr. Willis concerning his behavior, care, and completion of records. A letter is drafted and hand delivered to the physician by the chief of staff in a collegial manner. When given the letter in the hospital's hallway, Dr. Willis opens the letter, scans it, and laughs out loud. "Don't be ridiculous," he exclaims. "I'm not meeting with your stupid MEC about this or any other issue!"

The chief of staff is taken aback and returns to the MEC to explain the situation. The chief of surgery throws up his hands and says, "I guess that's it. There is nothing we can do."

If this situation could take place at your facility, your MEC needs a tool that is slightly stronger than gentle persuasion. The MEC needs a policy or bylaws provision regarding "special appearance requirements." Special appearance requirements, when included in the medical staff bylaws or established as a separate medical staff policy, effectively compel a physician to participate in discussions with the MEC (or an MEC subgroup) after receiving a formal notice requesting such a conference. Failure to participate in such discussions/conferences should be deemed a resignation from the medical staff and complete loss of clinical privileges until required discussions are held.

Physicians should not be able to avoid discussions with colleagues concerning performance or behavior. Permitting physician to avoid such discussions stymies the MEC and prevents it from fulfilling three of its most important obligations--effective communication, appropriate administration of medical affairs, and improvements in quality/patient safety.

If you would like a copy of special appearance requirement language developed by The Greeley Company, please email my executive assistant Diana Kuyper at Diana@greeleywi.com.

That's all for this week.

All the best,

Hugh Greeley



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