December 13, 2018

QUESTION:        We recently asked a physician to meet with our Leadership Council (a small group of Medical Staff leaders) to provide input regarding a concern about his behavior.  He says he’ll be happy to attend the meeting, but only if accompanied by his attorney.  Our policies do not address this issue – do we have to let the attorney attend the meeting?


ANSWER:            No.  The meeting is not a hearing.  It’s simply an opportunity for physicians to talk with one another in a collegial manner.  There’s no legal obligation to permit an attorney to attend, and the presence of an attorney would likely make the process less effective by making it seem more confrontational than it needs to be.

It’s much easier to address this situation when the applicable policy includes language such as the following:

  • To promote the collegial and educational objectives of this Policy, all discussions and meetings with a Practitioner shall generally involve only the Practitioner and the appropriate Medical Staff Leaders and Hospital personnel.  No counsel representing the Practitioner, Medical Staff or Hospital shall attend any of these meetings.

Of course, the physician may consult an attorney prior to the meeting (and the physician shouldn’t be discouraged from doing so).  The attorney can even accompany the physician to the hospital and wait in an appropriate location, if the physician insists.  But there’s no obligation to allow the attorney to accompany the physician during the meeting.

For more ideas on handling difficult peer review issues, check out our Peer Review Clinic.

November 2, 2017

QUESTION:        We have several clinical departments that have either weak chairs or chairs who are there entirely by “default.” These individuals are relied upon to perform a really important role.  How can we get stronger leaders interested?

ANSWER:            In many hospitals, it has been traditional to rotate the department chair position so that everyone gets his or her turn.  However, not every physician, quite frankly, has an aptitude for, or interest in, medical staff leadership.

One answer might be to develop stronger qualifications for serving in medical staff leadership roles, including officers and department chairs, and to provide for compensation for department chairs.  Another question to ask is if there are too many departments.  Consider consolidating departments.  By having fewer positions to fill, you then have a larger pool of qualified people who want to serve.

Finally, many hospitals are facing this very issue and are tackling it head on by incorporating an affirmative “succession development” process.  In these facilities, a small core group of medical staff leaders has an ongoing responsibility for identifying individuals who seem to show an aptitude for leadership and cultivating those skills – beginning with committee appointments and then moving them forward in the leadership track.