QUESTION: Our newly elected Chief of Staff is currently a department chair at our hospital. She really likes the department chair position and is good at it. At the same time, she also wants to fulfill the will of the Active Staff members who elected her to serve as the Chief of Staff. Can she serve both positions at the same time?
ANSWER: Serving in two leadership roles in the same hospital is not technically a conflict of interest, so unless there is a provision in the medical staff bylaws stating that an individual cannot serve in both roles, there is likely no technical reason that she cannot serve in both positions. That said, practically speaking, it may not be the best idea. Department chairs often have significant duties in terms of performing mentoring efforts and collegial counseling sessions with members of their departments in addition to their obligations to reviewing applicants for appointment and reappointment as well as service on the MEC. In large clinical departments, these responsibilities can be quite intensive. The Chief of Staff will generally be intimately involved in the active management of the most significant medical staff issues. Combine those two sets of responsibilities and it is a lot for one person to do, and to do well. In our experience, when department chairs or division chiefs are elected to serve as either the Vice Chief of Staff or the Chief of Staff, they have typically resigned the department chair/division chief position that they previously held.
QUESTION: How do we handle a situation when there is a physician on the Credentials Committee who is married to another physician, and the spouse’s application is up for consideration?
ANSWER: Every so often we run across physician couples. In those instances, there may be a situation in which the conflict of interest rules for credentialing or peer review activities are implicated. For example, imagine that Dr. Wright is appointed to the Medical Staff, is recognized as having good leadership qualities, and is appointed to the Credentials Committee. Then, his spouse applies for Medical Staff appointment. The application comes before the Credentials Committee and Dr. Wright is told “You can’t vote on the application” but Dr. Wright insists on voting, because “I know this applicant better than any other applicant that has been before this committee!”
Well, that may be so, but Dr. Wright can’t vote! Going back to compliance training and basic conflict of interest rules, Dr. Wright has a conflict of interest regarding his spouse’s application. He is emotionally involved in the outcome, and probably financially involved too. Of course, Dr. Wright can provide any relevant information he may have regarding his spouse and can answer any questions the Credentials Committee may have about her. But, after doing so, it’s prudent for him to leave the Credentials Committee meeting, and not participate in the discussion of his spouse’s credentials or the vote on the application. Also, the minutes should reflect that he left the meeting, the vote occurring after he left, and his return to the meeting.