Public Health Administrator Case: Aging & Recruited Physician

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Scenario One: The Aging Physician Scenario

Within this scenario there are several considerations the administrator must make prior to authorizing any act such as removing the privileges or credentials a physician at the facility. Within the scenario, there are two primary, but different, claims being placed in front of the administrator which call for the removal of Dr. Kirk from the facility's database: the physician can no longer perform at the required level to maintain the productivity standards of the hospital as set forth in the "Incentive Productivity System" (IPS) established by the facility's Executive Management Board approximately six month prior and there are claims made regarding Dr. Kirk's competency as a surgeon derived from perceivably credible sources. The key to making a successful decision in this case is simply performing due diligence on all claims and ensuring that the procedures being followed are in line with written hospital policy, as well as any federal, state or local laws, and that all parties rights and liberties are upheld and protected.

With due diligence being the driver, the first topic to consider is whether or not this decision falls under his authority. The administrator reports directly to the CEO who most likely reports directly to the Board of Directors. Stepping on these "BIG" toes would very likely be one of the, if not "the", last mistakes this administrator would like to make. Since the physician in question has such tenure at the facility, it is very likely he has a strong political presence there as well. This is frequently interpreted as having friends on the board...if he's not a board member himself. In this case the administrator begins the process of due diligence by communicating the issue to the CEO and seeking his advice prior to proceeding.

If in fact the decision is his and no one has any ill feeling about keeping or releasing the physician, the next step is to review the formal process for removal of physician privileges through the by-laws of the Medical Executive Board, Medical Credentialing Committee and the Medical Staff Board. Omitting this step invites the first barrage of lawsuits for many facilities that do not follow their own policies and procedures. It is very likely that actions such as these require a consensus among peers rather than simple removal base upon decreased bonuses. It is of paramount concern that this physician is actually being considered for termination based upon this reason given his recent affliction. The facility (and possibly the supporting physicians) is walking over very thin ice in regards to the Americans with Disabilities Act (ADA). This leads us to the ...