February 23, 2012

Question: Our hospital recently became part of a multi-health care system. The Chief Medical Officer of the System announced, at a recent Medical Executive Committee meeting, that one of the System’s top priorities was to standardize the medical staff bylaws and related policies. We’re not sure what this will mean to us or what role, if any, we will get to play in the process. Can you help us?

Answer: Many health care systems are recognizing the importance of having similar bylaws, policies and procedures throughout their organization. The standardization makes it easier for physicians who want to move from one hospital in the System to another. If they meet the standards for appointment and privileges at one hospital, they will meet the standard at the other hospitals in the System. And, there won’t be new policies or procedures to learn as they move from one system facility to the next. This benefit also extends to the System’s Chief Medical Officer and legal counsel who, with standardization, will not be forced to follow completely different policies for similar situations that occur in the different hospitals.

Having the same or similar bylaws, policies and procedures has the added benefit of ensuring or at least facilitating similar outcomes with respect to credentialing and privileging decisions. Different standards, without a rational basis, could be hard to explain in a legal challenge brought by a physician who was appointed to one system hospital and rejected at another or by an injured patient in a malpractice claim.

For most medical staffs, living through a hospital merger, consolidation, or acquisition can be a bit unsettling. There are often lots of questions about the new organization, including how it will function, how much will change, and the role physicians will play in it.

Resisting the change (including trying to hold on to past bylaws, policies, and procedures) is probably not the most productive approach. It would be better to make sure that physician leaders from your organization play a role in the transition. Make sure you attend meetings that are scheduled to discuss the transition and that you read newsletters and other information published about the transition. It would also be a great idea to volunteer to serve on key transition committees, like the Bylaws Task Force.

Try to maintain an open mind during the transition and be willing to bend. And keep your eye on the issues that are really important.