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Medical Staff Leader Insider

Issue 48, December 17, 2008

• Meeting management commandments

  Having a physician leader who can bring physicians together for a common cause is the key to...

• Ask the expert: When should the medical staff consider external peer review?

  External peer review isn’t appropriate for all situations,  but at times, it can be the...

• Tip of the week: Assertive leaders are not intimidating

  Assertiveness involves expressing yourself and your rights without making others uncomfortable or...

• Clarification

  Last week, Medical Staff Leader Connection reported that The Centers for Medicare & Medicaid...

Issue 47, December 10, 2008

• Peer Review Monthly: The M&M model is no substitute for peer review

  Robert Marder, MD, CMSL, vice president of The Greeley Company, shares why M&M conferences are...

• Tip of the week: Know the four basic leadership styles

  For a long time, people thought there were only two leadership styles: autocratic and democratic...

• Ask the expert: How can I get physicians to buy into using perception data?

  Because the use of perception data is new territory for most physicians, it is critical for...

Issue 46, December 3, 2008

• Follow the money: The strange and complex world of revenue cycle management

  The revenue cycle is a mysterious and complex process that seems disconnected from the primary...

• Tip of the week: Medical staff leaders need to know financial basics

  New medical staff leaders might need an MBA or MMM to understand all the intricacies of costs...

• Ask the expert: What policies should the medical staff have in place for medical students?

  Hospitals should have policies in place that govern medical students who participate in training...

• CMS updates CoPs

  The Centers for Medicare & Medicaid Services (CMS) updated the Conditions of Participation...

Issue 45, November 19, 2008

• Small Hospital Challenges Monthly: Do you need to update your documents?

  Mary Hoppa, MD, MBA, CMSL, discusses the importance of updating medical staff documents, including...

• Tip of the week: Get comfortable with change

  Various economic and political factors are creating drastic changes to the healthcare environment...

• Ask the expert: How often should our medical executive committee review our proctoring and FPPE program?

  An annual review is critical to a viable proctoring program—and don’t stop at sending...

Issue 44, November 12, 2008

• Peer Review Monthly: What should you call your peer review committee?

  Robert Marder, MD, CMSL, vice president of The Greeley Company, a division of HCPro, Inc., in...

• Ask the expert: Is peer review of individual cases considered perception data?

  Although peer review may seem like it would be considered perception data, our experts say...

• Tip of the week: Define physician competency measures

  When defining physician competency measures, make sure physicians are involved. Afterall, if...

Issue 43, November 5, 2008

• Pearls for leaders

  Every once in a while, I read a book that has concise “pearls” that I find both...

• Ask the expert: What is an automatic suspension or relinquishment?

  Last week, we defined and described the purpose of a precautionary suspension. This week, we...

• Tip of the week: Use role-playing to develop physician leaders’ communication skills

  Haven’t tried role-playing to hone your communication skills? Give it a shot. It may help...

Issue 42, October 29, 2008

• Medical staff members on governing boards: Critical expertise or conflict of interest?

  Jon Burroughs, MD, MBA, CMSL, a senior consultant at The Greeley Company, says that thoughtful...

• Ask the expert: What is a precautionary suspension?

  Many hospitals have adopted the term precautionary suspension to better reflect the nature of a...

• Tip of the week: Understand the role of a proctor

  Sometimes the best way to understand something is to understand what it is not. When bringing new...

Issue 41, October 22, 2008

• Great to see you at NAMSS!

  Last week, I had the pleasure of attending the National Association of Medical Staff Services...

• Tip of the week: Understand the characteristics of a good leader

  Wondering what—exactly—is the definition of a good leader? Here is a list leaders in...

• Ask the expert: What is a summary suspension?

  Summary suspensions, automatic suspensions, precautionary suspensions—over the next few...

Issue 40, October 10, 2008

• Small Hospital Challenges Monthly: Proctoring in small hospitals

  Mary Hoppa, MD, MBA, CMSL, senior consultant with The Greeley Company, gives small hosptials some...

• Tip of the week: Stipends can be useful tool to compensate physicians taking ED call

  The most common form of compensation for on-call service is a stipend. Although the approach...

• Ask the expert: What language should I use in a positive feedback letter?

  When saying thank you to physicians on your staff, it is important they know what they are being...

Issue 39, October 1, 2008

• Five dynamic tensions in contemporary medical staffs: Conclusion

  This is the conclusion to our seven-part series on the five dynamic tensions of contemporary...

• Tip of the week: Make ED call everyone’s responsibility

  Rather than requiring only particular staff categories to take such call, many medical staffs are...

• Ask the expert: Does failing to act on a request for reappointment have legal implications?

  Yes. Your organization’s policies should clearly outline the time frame by which it must act...

• Peer Review Monthly: Why is peer review hard to do?

  Robert Marder, MD, CMSL, vice president of The Greeley Company, a division of HCPro, Inc. in...

• Tip of the week: Define "investigation" in your bylaws

  It is important to have a crystal-clear definition of “investigation” in your bylaws...

• Ask the expert: What are some of the benefits of physicians and hospitals joint venturing?

  Learn why joint ventures are such a desirable option for both physicians and hospitals in...

Issue 38, September 24, 2008

• MSP Advisor: Credentialing basics are not just for beginners!

  This month is the third installment of a eight-part series written by Donna K. Goestenkors, CPMSM...

• Tip of the week: Ditch the paragraph in your bylaws that states your organization’s name

  Is stating your organization’s name on the coversheet of your bylaws enough? Our Greeley...

• Ask the expert: What role does personality profiling play in hospitalist recruitment?

  In addition to a mentoring program and feedback forum, there are other strategies that can help...

Issue 37, September 17, 2008

• Small Hospital Challenges Monthly: Retention is as crucial as recruitment

  Mary Hoppa, MD, MBA, CMSL, highlights the need for small hospitals to put as much focus on...

• Ask the expert: What is an intended practice plan?

  Under an intended practice plan model, part of the application process involves asking physicians...

• Tip of the week: Understand the relationship between hospitalists and specialty hospitalists

  Understanding the role hospitalists play in your organization will help you develop a stronger...

Issue 36, September 10, 2008

• Peer Review Monthly: Case studies in peer review

  Robert Marder, MD, CMSL, shares a case study from a new book he co-authored with Jonathan H...

• Ask the expert: What should you tell potential leaders about the burdens, challenges, and risks of assuming a leadership role?

  Assuming a leadership position has its burdens, as anyone involved heavily in medical staff affairs...

• Tip of the week: Set priorities!

  Sometimes you may think that you’ve successfully outlined your proiorities for the day, but...

Issue 35, September 3, 2008

• Five dynamic tensions in contemporary medical staffs part 5: Stability and change

  Mark your calendars! This series on the five dynamic tensions of the medical staff by William K...

• Tip of the week: Allowing disruptive physicians to confront their accusers is counterproductive

  When an individual in your organization submits a complaint about a physician, the physician may...

• Ask the expert: What benefit does a "kitchen cabinet" serve?

  Some hospital CEOs have hand-picked a group of physicians to form their own "kitchen...

Issue 34, August 20, 2008

• MSP Advisor: Creating a process and procedure manual

  This month, Medical Staff Leader Connection presents the second installment of an eight-part series...

• Ask the expert: To merge or not to merge? Dispelling another myth

  Last week, we dispelled a common misconception hospitals often subscribe to when considering a...

• Tip of the week: Create position descriptions for key medical staff leaders

  Certain leadership positions are critical to the success of the medical staff and hospital, and...

• Tip of the week: Create position descriptions for key medical staff leaders

  Certain leadership positions are critical to the success of the medical staff and hospital...

Issue 33, August 20, 2008

• Small Hospital Challenges Monthly: Pay-for-performance

  Mary Hoppa, MD, MBA, CMSL, discusses the challenges small hospitals face when adopting a physician...

• Ask the expert: To merge or not to merge? That is the question.

  Hospitals sometimes subscribe to merger myths when they consider joining forces with another...

• Tip of the week: Avoid using a one-size-fits-all FPPE process

  Although a one-size-fits all approach to FPPE may make your policy simpler, it creates unnecessary...

Issue 32, August 13, 2008

• Peer Review Monthly: Auditing indications for high volume procedures

  Robert Marder, MD, CMSL, vice president of The Greeley Company, a division of HCPro, Inc. in...

• Tip of the week: Understand hospitalist lingo

  To foster communication between hospitalists and other healthcare providers, it is important to...

Issue 31, August 5, 2008

• Five dynamic tensions in contemporary medical staffs part 4: Appreciation and continuous performance improvement

  Mark your calendars! This series on the five dynamic tensions of the medical staff by William K...

• Tip of the week: Physicians should receive feedback from their peers

  When physicians receive feedback about their behavior, that information is most often relayed by...

• Poliner decision reversed: August 22 audio conference presented by HCPro

  Join HCPro on Friday, August 22 for Poliner Decision Reversed: Strategies for Effective Peer Review...

• Ask the expert: How can MSPs get the support of hospital leaders?

  The support of medical staff leaders and administrative leaders can make life vastly easier for...

• Ask the expert: How can MSPs get the support of hospital leaders?

  The support of medical staff leaders and administrative leaders can make life vastly easier for...

Issue 30, July 30, 2008

• Medical Staff Alert: Poliner decision overturned

  Physicians who have been reluctant to participate in peer review activities can relax a bit knowing...

• Physician equity: Will this medical staff model work for your facility?

  The physician equity medical staff model works for some facilities–can it work for yours?This...

• Tip of the week: Overcome procrastination to benefit everyone in the MSO

  Procrastination is the art of keeping up with yesterday. When you feel the urge to procrastinate...

• Ask the expert: Are there different types of ED call pay?

  In general, there is restricted on-call pay and unrestricted on-call pay. Deciding which type of...

Issue 29, July 23, 2008

• Medical Staff Alert: New Medicare law changes Joint Commission deeming authority status

  Congress last week overrode a presidential veto of the Medicare Improvements for Patients and...

• MSP Advisor: Assessing and choosing software for your MSO

  This month, we begin a new eight-part series written by Donna K. Goestenkors, CPMSM, a...

• Ask the expert: What does zero tolerance mean?

  When addressing disruptive physician behavior, organizations must understand an often confusing...

• Tip of the week: Create OPPE quality indicators specific to your organization

  Organizational culture, patient volume, and the types of services your organization offers ...

Issue 28, July 16, 2008

• Small Hospital Challenges Monthly: Medical staff leadership challenges

  Mary Hoppa, MD, MBA, CMSL, discusses how medical staff leadership challenges can be overcome...

• Tip of the week: Develop a master calendar

  The structure of the medical staff office (MSO) depends on the defined responsibilities and...

• Ask the expert: What incidents must be reported to the National Practitioner Data Bank?

  Figuring out what incidents need to be reported to the National Practitioner Data Bank can be...

Issue 27, July 9, 2008

• Peer Review Monthly: Why use a scoring system for peer review?

  At a recent Greeley Company national seminar, a physician leader asked me why peer review...

• Medical Staff Alert: The Joint Commission releases 2009 standards

  On July 1, The Joint Commission published its revised standards, rationales, and elements of...

• Tip of the week: Surviving medical staff leadership

  Being a medical staff leader can be a positive, educational experience, but it can also be trying...

• Ask the expert: How should a hospital decide whether to adopt an innovative technology or procedure?

  The Deming philosophy of management, developed by William Edwards Deming, PhD, has helped numerous...

Issue 26, July 2, 2008

• Five dynamic tensions in contemporary medical staffs part 3: Balancing independence and mutual accountability

  Independence enables physicians to exercise their clinical judgment and skills in the best...

• Ask the expert: How should our hospitalist program measure patient satisfaction?

  To provide physicians with critical patient satisfaction information, hospitalist programs should...

• Tip of the week: Build a strong team

  The role of an MSP can be very stressful, time-consuming, and challenging. It is important for...

Issue 25, June 25, 2008

• Medical staff leadership: Pulling all of the pieces together

  This is the last installment of my current series that defines the steps every new and experienced...

• Ask the expert: What are relative value units?

  Relative value units (RVU) are the standard measures of physician services or the procedures...

• Tip of the week: Maximize your PR capabilities

  The medical staff office is the public relations and information department for the medical staff...

Issue 24, June 18, 2008

• Medical Staff Alert: Joint Commission releases 2009 National Patient Safety Goals

  The Joint Commission announced its 2009 National Patient Safety Goals (NPSG) and elements of...

• Small Hospital Challenges Monthly

  Financial constraints, increased regulation, and heightened scrutiny from the general public are...

• Tip of the week: Take this quiz to determine if you are time conscious

  Unless you cultivate respect for time and are continually conscious of its passage, you are apt to...

• Ask the expert: What are adequate rewards to entice medical staff members into leadership roles?

  In the past, the stature of holding a leadership role in the hospital was reward enough for most...

Issue 23, June 11, 2008

• Peer Review Monthly: FPPE: How many prunes are enough?

  Remember that old laxative commercial in which the actor ponders how many prunes will do the job...

• Ask the expert: How should hospitals assess vendor competency?

  An issue that has raised a lot of questions in the field is how organizations can ensure that...

• Tip of the week: Create a hospitalist brochure to communicate with patients

  Hospitalist medicine is still in its infancy, and most patients are being placed under the care of...

Issue 22, June 4, 2008

• Five "dynamic tensions" in contemporary medical staffs part 2: Balancing freedom and commitment

  Many medical staffs have difficulty finding the balance between freedom and commitment. In this...

• Medical Staff Alert: Joint Commission delays MS.1.20 decision

  The Joint Commission (formerly JCAHO) Board of Commissioners followed the recommendation of a task...

• Tip of the week: Helpful hints for effective minute taking

  Minute taking is an important skill—especially in a medical staff office. These tips will...

• Ask the expert: How should physician leaders handle whistleblowers?

  It is not uncommon for disruptive physicians to claim they are the champions of good medical...

Issue 21, May 28, 2008

• The Kadlec Medical Center case: Lessons learned

  This month, the U.S. District Court for the eastern division of Louisiana overturned t decision...

• Ask the expert: How should MSPs handle leaves of absence?

  Medical staff policies generally allow a medical staff member to obtain, for good cause, a...

• Tip of the week: Develop physician-extender supervised call policies to help reduce ED call burden

  Allied health professionals (AHPs) represent one of the fastest growing fields in medicine and can...

Issue 20, May 21, 2008

• EC.9.10: The "other" EOC standard

  Unlike the first seven standards, EC.9.10 does not require a written management plan. Therefore, it...

• Tip of the week: MSPs need to learn to delegate

  Whether you’re on your own in the medical staff office (MSO) or you manage other staff...

• Ask the expert: What constitutes disruptive behavior?

  Is it disruptive behavior or just a bad mood? It is important to include specific examples of...

Issue 19, May 14, 2008

• Advanced meeting management: Dealing with disruptive physicians during meetings

  Dealing with a disruptive physician is difficult enough when you have time to plan for an...

• Tip of the week: Physicians need to let go of chart review

  The biggest obstacle to successfully using review, rate, and rule indicators seems to be...

• Ask the expert: Should physicians be paid to perform peer reviews?

  The answer to this question is based on a number of factors, including to what degree your medical...

Issue 18, May 6, 2008

• Peer Review Monthly: Improving physician-nurse relations by following the six general competencies

  As I recently prepared a quality and peer review educational program for a medical staff, the...

• Tip of the week: Develop effective meeting agendas

  Last week, we discussed planning effective meetings, and the week before, we explored different...

• Ask the expert: How can a medical staff identify members with leadership potential?

  Proactive recruitment means finding physicians on the medical staff who have the ability to lead...

Issue 17, April 30, 2008

• Tip of the week: Plan effective meetings

  Effective meeting management requires diplomacy and proven management techniques. Physician leaders...

• Ask the expert: What is the MSP's role in medical staff reappointment?

  The medical staff professional (MSP) is responsible for processing and maintaining...

• Five dynamic tensions in contemporary medical staffs part 1: Balancing collegiality and excellence

  As a member of the medical staff, your fellow physicians should have your unconditional respect as...

Issue 16, April 16, 2008

• Tip of the week: Time management skills for MSPs

  The medical staff professional’s job is always going to be stressful, and there is no way of...

• Ask the expert: When conducting peer review, who can be considered a peer?

  Traditionally, a peer has been defined as an individual in the same specialty. However, as...

• EC.8.10: The "other" EOC standard

  When consulting with clients, I frequently ask them how they are complying with EC.8.10, one of the...

• Tip of the week: Understand physician leaders' meeting management styles

  If you chair meetings for your medical staff, or if you work with or supervise someone who does...

• Ask the expert: How can medical staff leaders become better listeners?

  Communication is key to successfully leading the medical staff. Timely communication is essential...

Issue 15, April 9, 2008

• Tip of the week: Communicate effectively with medical staff members

  It seems no matter how hard MSPs and medical staff leaders to try communicate important...

• Ask the expert: What factors affect the cost of launching a new technology or service?

  Direct-to-patient marketing by hospitals to tout a procedure, such as carotid stenting or...

• Peer review monthly: Should the medical staff quality committee be responsible for hospital PI?

  In helping hospitals design effective medical staff quality committees to oversee their peer review...

• If you build it, they will come

  Strategic planning is a business term that many in healthcare environments have  associated...

Issue 14, April 2, 2008

• Five dynamic tensions in contemporary medical staffs: Introduction and overview

  There is a saying making the rounds in healthcare today: If culture and strategy are not aligned...

• Tip of the week: Provide physician leaders with a clear job description

  Ask a physician leader what his or her job is, and you most often get a blank stare. After some...

• Ask the expert: What materials should be included with physician competency reports?

  In addition to the report itself, the medical staff office should provide physicians with...

Issue 13, March 26, 2008

• Constructive discipline--An oxymoron?

  Many of us fear and avoid dealing directly, constructively, and meaningfully with our colleagues...

• Tip of the week: Send courtesy reminders to keep busy docs on track

  MSPs often struggle to receive information in a timely manner. Although the responsibility for...

• Ask the expert: What are rate, rule, and review indicators?

  The Greeley Company has developed a way to describe physician performance measurement tools that...

Issue 12, March 19, 2008

• Constructive Discipline: Part 1

  Benjamin Spock taught the baby boomer generation that discipline was punitive, potentially...

• Tip of the week: Streamline your medical staff categories

  Medical staffs often have several categories and subcategories to describe all of their members...

• Ask the expert: How should physicians receive positive feedback?

  One basic principle should guide all efforts to provide physicians feedback: praise in public and...

• HCPro, Inc. launches new logo and tagline

  HCPro, Inc. is launching a new corporate branding campaign designed to reflect the company’s...

Issue 11, March 12, 2008

• Peer Review Monthly: Defining peer review

  In the coming months, I hope to address challenges you face in performing peer review, a critical...

• Ask the expert: What is the best way to analyze staffing requirements for the MSO?

  Surprisingly, the staffing level in the typical medical staff office (MSO) has very little to do...

• Tip of the week: Plan before you privilege

  Some hospitals are innovators, always on the cutting edge of new technology. Other hospitals are...

Issue 10, March 5, 2008

• Becoming an effective medical staff leader: Create a vision

  In past columns, I have offered tips and advice for becoming an even more effective medical staff...

• Ask the expert: Who is obligated to take emergency department calls?

  In the past, no physician refused emergency department calls under any circumstances. Recently...

• Tip of the week: Don't be afraid to use external review when appropriate

  Hospitals should have a policy that clearly describes the circumstances under which it would seek...

Issue 9, February 27, 2008

• What would a culture of appreciation and respect look like?

  Most of us were trained as physicians through an educational culture that extends back to the...

• Ask the expert: Correction to last week's proctoring question

  Editor's note: Last week's "Ask the expert: Who is likely to sue as a result of improper or...

• Tip of the week: Run a successful committee

  Running a committee can be a time-consuming, challenging position, as it requires you to coordinate...

Issue 8, February 20, 2008

• Clinical privilege myth #4: There are "textbook" criteria available for delineating clinical privileges

  Because "textbook" criteria are not often available for delineating clinical privileges, the...

• Ask the expert: Who is likely to sue as a result of improper or inadequate proctoring?

  Medical staffs have discretion in the deployment of proctoring, and any time discretion is...

• Tip of the week: Enjoy being an MSP

  On one hand, being an MSP can be stressful and, at times, frustrating because you may not have the...

Issue 7, February 13, 2008

• Clinical Privilege Myth #3: A physician is entitled to all requested clinical privileges unless not sufficiently trained or qualified

  Although some physicians may argue otherwise, a competent and appropriately trained physician is...

• Ask the expert: Are all no- or low-volume providers created equal?

  You cannot handle all no- and low-volume providers in the same manner. The approach a hospital...

• Tip of the week: Understand the inherent differences between physicians and managers

  Different backgrounds and training can strain the relationship between the medical staff and...

Issue 6, February 7, 2008

• Clinical privilege myth #2: Clinical privileges are defined, determined, and granted by the clinical departments

  A medical staff member wishes to apply for new privileges to perform carotid artery stenting. The...

• Ask the expert: What is the definition of a clinical assistant?

  A clinical assistant is a type of allied health professional that does not require privileging...

• Tip of the week: Reduce the number of medical staff meetings to save money

  Although it is important for the medical staff to meet regularly, streamlining your process can...

Issue 5, January 30, 2008

• Clinical privilege myth: Clinical privileges are owned by physicians

  It is always useful to examine and dispel common myths regarding clinical privileges. One of the...

• Tip of the week: Be smart about collecting data to use in your physician competency reports

  Last week, we discussed selecting the right indicators for your physician competency report. Once...

• Ask the expert: In my hospital, who should be categorized as an AHP?

  That decision is up to your hospital and the state. Some institutions consider dentists...

Issue 4, January 23, 2008

• Communication tips for medical staff leaders

  Dear medical staff leader, Whether you are planning an intervention or simply trying to...

• Tip of the week: Select appropriate indicators for your physician competency report

  In the past, hospitals created their own indicators for evaluating physician performance, but...

• Ask the expert: What is the role of paid medical management?

  Surprisingly, the role of paid medical management, such as the chief medical officer, vice...

Issue 3, January 17, 2008

• Tip of the week: Investing in physician leaders

  Medical staffs that achieve tangible outcomes from their leadership training programs are those...

• Ask the expert: How should perception data be collected?

  Last week's "Ask the expert" column addressed when it is appropriate to use perception data to...

• Planning and practicing an intervention

  Dear Medical Staff Leader, Last week's issue discussed planning an intervention as soon as a...

Issue 2, January 10, 2008

• Prepare for physician intervention

  Prepare for physician intervention Dear medical staff leader, In last week's Tip of the Week, we...

• Tip of the week: Recognize differences between QA and QI

  Quality improvement (QI) involves proactively evaluating an organization's functions, services...

• Ask the Expert: When should we use perception data?

  In the past, most hospitals have relied on clinical data to evaluate physician performance, but...

Issue 1, January 4, 2008

• Part 4: Strategies for solving the challenges posed by low-volume providers

  Dear medical staff leader: Many organizations have faced the challenges posed by a practitioner...

• Tip of the week: Proactively manage poor performance

  Many medical staff leaders are uncomfortable approaching physicians whose performance has been...

• Ask the Expert: What should a medical staff leader job description include?

  A medical facility's culture, size, and location (urban or rural) will dictate the specifics of...

Issue 14, April 4, 2008

• Universities aid bilingual nursing students in career development

  The hunger for bilingual nurses is higher than ever due to the growing number of patients in the...

Issue 12, March 21, 2008

• Web site spotlight

  "Here is a quick idea that costs only about 2 minutes of time: Even though you may have thanked an...

Issue 31, August 5, 2008

• Ask the expert: What are some of the occupational hazards department chairs may face?

  A promotion to department chairs is a significant moment in a physician’s career, but they...