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The Value of Medical Staff Services

February 22, 2021

The critical behind-the-scenes duties of the Medical Services Team that keep hospitals compliant and the quality of their healthcare providers to a high standard.

In this blog, Hugh Greeley describes the critical functions of a fine-tuned medical staff services team.  While there are boards and committees in place governed and populated by members of the C-Suite and pedigreed physicians that participate in screening medical licensed staff, it is the medical staff services team that really gets to the heart of properly vetting candidates.

Vet Twice, Hire Nice

The hiring process has stages from when an applicant’s package is in consideration, to the offer, to onboarding. The critical time to halt a process is before the applicant’s package goes to the credentialing committee, is considered by the board, and certainly, before an offer is made. If there are missing elements to the application package, or if there is a questionable result on a background search, or adverse behavior history revealed from a medical license verification or FACIS® search, the applicant will need to produce any missing information, and staff should adhere to hospital bylaws and best practice hiring rules to decide how to handle evidence of current or past adverse behavior.

The following is contributed by Hugh Greeley, author of Hugh’s Credentialing Digest

This week’s column is about lessons learned during a weekend physician leadership retreat, and it begins with this question: “Please tell me why we have to do all this stuff. If a doc is licensed and board-certified, who are we to determine if he is qualified to practice?”

This query was posed by a seemingly brilliant orthopedic surgeon who had been elected president of his medical staff. He was elected as a protest by only 17 percent of the active staff. [For purposes of discussion, assume that the staff had 100 active staff appointees. Also, assume that they had very antiquated bylaws that called for an election at the annual meeting of the staff. Also assume that said bylaws required as a quorum 33 percent of the staff (a recent bylaws change, due to the fact that most physicians had lost interest in staff meetings). Finally, assume that being elected required 51 percent of those present when the quorum was established. Of the 33 people present when the election was held, 17 voted for the orthopedic surgeon, who was nominated from the floor.]

While the above may give rise to a relatively dysfunctional medical staff for the next year, it is unlikely that it will have much impact upon patients or upon most of the staff members. Physicians who have sought and gained employment at this hospital’s multi-specialty group provide most of the care at the hospital (another couple of dozen are not employed but have exclusive contracts with the hospital). These physicians have long been excluded from leadership activities within the medical staff and have chosen to work with the hospital through their group. In addition to half a dozen committees, they also have a leadership council that meets with the CEO, VPMA, COO (who is also director of patient care), and CFO each month.

These meetings are, reportedly, well attended and results-orientated. The CEO says that “this is where we actually make progress and improve our systems.” He does not attend the medical executive committee meetings, preferring to delegate this responsibility to the VPMA.

Experienced Medical Staff Services Run an Excellent Credentialing System

The credentialing system at the hospital is excellent, and it relies upon a very experienced medical staff professional who carefully vets any prospective physician seeking employment. This is done in advance of an actual offer. In five years, the hospital has not employed a single problem physician. It has declined to offer employment to those found to be licensed and board-certified, but who did not possess a sterling professional practice record.

4 Keys to Effective Credentialing

What might we learn from this staff? First, physicians who chafe against the change in physician practice preferences and express their displeasure through the medical staff may well find that they become irrelevant. Second, any staff that still permits floor nominations deserves what it gets (unvetted, unprepared, and often recalcitrant leaders). Third, employed physicians will find a way to work with the hospital because it is in their own and their patients’ best interests to do so. Fourth, work hard to assure that staff bylaws do not cast employed physicians as second-class citizens.

Hugh Greeley Written by Hugh Greeley
Credentialing and Healthcare Industry Expert
HG Healthcare Consultant
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