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What should not trigger a fair hearing?

Hospitalist Leadership Connection, October 25, 2007

Dear medical staff leader:

Last month we talked about the actions that should trigger a fair hearing and appeal due process.

Let us now talk about and clearly state what actions should not trigger a fair hearing. In general, unless an adverse recommendation pertains to clinical incompetence or unprofessional conduct, the fair hearing due process should not be triggered.

Some examples of actions that should not trigger a fair hearing are:

• Issuance of a letter of guidance, warning, or reprimand
• Imposition a precautionary suspension or disciplinary time-out lasting less than 14 days
• Automatic relinquishment or voluntary resignation of appointment or clinical privileges
• Denial of a request for a leave of absence, or for an extension of a leave of absence
• Determination that an application is incomplete or will not be processed due to a misstatement or omission
• Any performance monitoring requirements required by the Joint Commission standards for focused professional practice evaluation (FPPE)
• Not being granted a clinical privilege because of not meeting the established minimal threshold criteria for that privilege
• Not being eligible for privileges that are granted only via an exclusive contract arrangement
• Change of staff category or department assignment
• Conditional appointment for duration of less than 24 months

Automatic suspensions of privileges for administrative actions such as loss of licensure, Drug Enforcement Agency registration, malpractice insurance, or medical records completion should not trigger a fair hearing either. Having a clear understanding that only adverse recommendations pertaining to clinical incompetence or unprofessional conduct trigger a fair hearing will serve you well and prevent unnecessary time, agony, money, and medical staff leadership burnout.

Joseph Cooper, MD
The Greeley Company

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