1. Work through the medical staff. Ms. Bittinger says hospitals already have a medical staff hierarchy that contains committees on quality, productivity and communication between physicians and nursing staff. Hospital administrators should work through that medical staff system to promote physician-hospital alignment. “If you’re going to put employed physicians in leadership positions, you need to make sure those positions don’t conflict with the medical staff leadership,” Ms. Bittinger says. “If physicians are hearing two different things from employed physician administrators and the head of their departments, that can leave them thinking, ‘Who is in charge here?'” Make sure your employed physician leaders and medical staff leaders are working together to respond to physician complaints, think about strategic direction and improve quality of care.
2. Involve physicians in decisions about purchasing and service line development. Overall, Ms. Bittinger says, physicians and hospitals are naturally aligned in terms of financial goals. However, when hospitals make decisions about purchasing new equipment or developing a new service line, they might not think to include physicians on the decision-making committee — a mistake, since physicians are intimately connected to and affected by those changes. “Physicians should be on board with analyzing the service, giving feedback and really being a part of the process,” says Ms. Bittinger. “Listen to their input. Don’t just appoint them as figureheads.”
Problems come up when the hospital makes decisions that have a financial impact on physicians and don’t take the physicians into consideration, Ms. Bittinger says. “If you provide an exclusive contract to a group that shuts out some folks that are currently on staff, that’s going to upset people,” she says. “That can be avoided if you talk to your physicians about decisions before you make them. No physician wants to hear through a memo or his morning newspaper that you’ve added a new service line that affects him or her.”
3. Be careful of kickbacks. Ms. Bittinger says it’s easy for good hospital-physician relationships to spill over into illegal territory. “You have to be very careful of federal anti-kickback statutes,” she says. “Promoting relationships between physicians and hospitals does not mean filling the hospital’s box at the football game with physicians.” She says hospitals should be aware that even seemingly innocent gestures, like throwing a medical staff party, can be violations to the anti-kickback statute. “Don’t even buy donuts and put them in the medical staff office. You just don’t want to risk it,” she says. “You have to be really, really careful.”
Learn more about Bittinger Law.
