QUESTION: Our Medical Staff Bylaws require all bylaws amendments to be accomplished at an officially called, in-person meeting. As a result, we have been compiling revisions for months (years?) because of the logistics involved in getting this done. The issue has now come to a head because we have revisions that really have to get into our Bylaws in preparation for an upcoming survey. Do medical staffs really still vote on bylaws amendments in meetings? No one shows up for meetings any more — even before the complications created by the current pandemic! Is this still a current practice? Should it be?
ANSWER: In our experience working with medical staffs across the country, the answer has pretty clearly become no. While it was traditional for big things — like bylaws amendments and voting on medical staff officers — to occur in in-person medical staff meetings, that tradition has been changing significantly over the past decade. The negative spin on the move away from in-person voting is that people have stopped showing up for meetings — there just isn’t enough time in the day for all of the patient care issues that have to be addressed to then make time for medical staff citizenship obligations. However, what we hear most often is the positive side of this coin — which is that by moving away from in-person meetings to take action, which, no matter when they are held (early morning, lunchtime, or late afternoon/evening) will exclude some portion of the medical staff, it is a way to get the input of a much more board cross-section of the medical staff. The reality is that folks have more time to read an email that includes the proposed amendment and a description of the rationale than they to do attend a meeting.
We have also worked with a number of medical staffs that have opted to “open forum” meetings to discuss proposed bylaws amendments (generally when there is a comprehensive revision process underway), but then conduct the actual vote through email or other electronic ballot — again, attempting to reach as many members of the medical staff as possible.