Physicians who speak out

Although hospital administrators and physicians on the medical staff need to work harmoniously for the common interests of patients, it is mighty important for medical staffs to remain independent at the same time, particularly in matters concerning medical care. In my 33 years of practice as a staff physician in three hospitals ( as a Department chief and later president of the medical staff in the largest hospital), I have come across problems, none of which were major, which were all satisfactorily settled.

The key here is in maintaining close rapport not only with the administration, but with the Board of Commissioners which has final say on any matters concerning the over-all operations of the hospital.
The Board is made up of citizens representing a broad spectum of the community, with medical staff representation. It would have been impossible, under this set-up, for the administrative staff to embark on policies that would collide with physicians’ interests, particularly when it comes to patient care.

Just one observation: There was a time, about 10 to 15 years ago, when economic credentialing became a hot issue in Florida because of the tight economic competition, made worse by the advent of managed care, which polarized the medical community. Scattered areas in the state
have been caught in this web and resolution of the problem is still going on pitting physicians against the hospitals.

I’m glad DB is devoting some space to this issue. As far as I can see, it is not a major issue in my state, but it is something to be aware of to avert the types of fiascos that can ensue when physicians clash against their own hospitals.

Although hospital administrators and physicians on the medical staff need to work harmoniously for the common interests of patients, it is mighty important for medical staffs to remain independent at the same time, particularly in matters concerning medical care. In my 33 years of practice as a staff physician in three hospitals ( as a Department chief and later president of the medical staff in the largest hospital), I have come across problems, none of which were major, which were all satisfactorily settled.

The key here is in maintaining close rapport not only with the administration, but with the Board of Commissioners which has final say on any matters concerning the over-all operations of the hospital.
The Board is made up of citizens representing a broad spectum of the community, with medical staff representation. It would have been impossible, under this set-up, for the administrative staff to embark on policies that would collide with physicians’ interests, particularly when it comes to patient care.

Just one observation: There was a time, about 10 to 15 years ago, when economic credentialing became a hot issue in Florida because of the tight economic competition, made worse by the advent of managed care, which polarized the medical community. Scattered areas in the state
have been caught in this web and resolution of the problem is still going on pitting physicians against the hospitals.

I’m glad DB is devoting some space to this issue. As far as I can see, it is not a major issue in my state, but it is something to be aware of to avert the types of fiascos that can ensue when physicians clash against their own hospitals.