The Most Common Medical Staff Problems and Issues and How to Handle Them

At the Becker's Hospital Review Annual Meeting in Chicago on May 18, Tom Stallings, partner at law firm McGuireWoods, discussed the most common medical staff-related lawsuits and how to handle them.

The federal Healthcare Quality Improvement Act is designed to promote a meaningful peer review process without the threat of liability. Essentially, courts allow hospitals and health systems to conduct a peer review of a staff member, as long as it is conducted in good faith; in the best interest of patient care; and in accordance with specific procedures.

Who is immune to liability? The federal law defines the "professional review body" broadly and could include the hospital itself, members of the medical staff, members of medical staff committees, the governing board and lawyers. The federal law is also designed to discourage litigation. When a defendant (the hospital) prevails, the court must order the plaintiff (staff members) to pay the defendant's attorney's fees and other costs.

The federal law includes other notable provisions. These include privileges and confidentiality. Although most documentation is considered "fair game" in litigation, the federal law provides privileges under which certain documents or exchanges are kept confidential, including the attorney-client privilege. Healthcare organizations must also account for:

•    Understand reporting obligations to the federal government's National Practitioner Database.
  • Note: Under federal law, healthcare organizations must report disciplinary action if it affects the privileges of a physician for longer than 30 days. State-specific laws may change this scope.
•    Disruptive physicians may not directly impact patient care, but healthcare organizations should include this issue in the peer review process.
•    Review all authorizations and releases carefully and develop standard practices for responding.

Mr. Stallings provided other practice advice:

•    Be proactive.
•    Periodically review and revise bylaws.
•    Follow the bylaws.
•    Understand state and federal law.
•    Involve legal counsel at beginning of the process.
•    Understand your hospital insurance policy and ensure peer review process is covered.

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