Hospitals have a duty to oversee the quality of care provided by physicians, which includes monitoring competency and professional conduct through the medical staff credentialing and peer review processes. When issues arise related to a doctor’s performance or behavior, disciplinary action may be warranted in accordance with the hospital’s medical staff bylaws.
Frier Levitt Partners Todd Brower and Alex Keoskey provided a comprehensive overview of this complex disciplinary process in Part 1 of the complimentary 3-part webinar series entitled, “Exploring Hospital and Physician Dynamics: A Primer on Medical Staff Adverse Actions.”
Key takeaways of Part 1, “Understanding the Disciplinary Process” included an overview of the various types of corrective actions available to hospitals, such as immediately enacting a summary suspension if a doctor poses an imminent threat to patient safety. For less emergent situations, routine corrective action (e.g., FPPE, OPPE, RCA, etc.) may be utilized for matters like substandard care, disruptive conduct, or other reportable events. If the issues are not resolved, further corrective action may be warranted including curtailing some or all of a physician’s privileges. Such action may then trigger a fair hearing (a “mini-trial)” with both the medical executive committee and the affected physician presenting evidence before a hearing panel, aided by legal counsel, and with appeal rights to the governing board.
A significant portion of Part 1 focused on the reporting requirements to the National Practitioner Data Bank (NPDB) for certain actions. Examples of reportable incidents that were discussed include certain medical malpractice payments, adverse actions taken by healthcare entities related to professional conduct or competence, licensure or certification actions, and healthcare related convictions or judgments. While not binding legal authority, the NPDB guidebook provides critical guidance to healthcare entities on properly documenting and submitting these reports.
Importantly, the federal Health Care Quality Improvement Act (HCQIA) provides immunity and legal protections for hospitals engaging in good-faith professional review activities prioritizing quality patient care. However, the presenters examined whether existing bylaws offer sufficient due process for physicians facing disciplinary actions under professional review. Other areas of debate included applying progressive disciplinary models, the degree of attorney involvement in hearing processes, and the perceived targeting of outspoken doctors.
While hospital bylaws aim to ensure patient safety and quality care, reasonable minds may disagree on what constitutes a legitimately reportable incident versus an unfair targeting. Communication breakdowns between hospitals and doctors, as well as between physician peers, further escalate these tensions. These issues set the stage for Part 2 of the webinar series entitled, “Civility and Communication: Managing Disruptive Physicians and Addressing Harassment Complaints,” which airs live on June 25, 2024. This discussion will explore the effect of disruptive behavior on patient care, and attendees will gain insight on how to proactively mitigate conflict through improved policies and procedures. Lastly, stay tuned for Part 3, “Adverse Action Reporting: The Consequences of a Permanent Record,” which will take place virtually on July 10, 2024.
Watch Part 1, “Understanding the Disciplinary Process” HERE.
Register for Part 2, “Civility and Communication: Managing Disruptive Physicians and Addressing Harassment Complaints” HERE.
Register for Part 3, “Adverse Action Reporting: The Consequences of a Permanent Record” HERE.
We hope to see you there!
