Regarding Joint Commission should end MS.1.20 push:
The relationship of medical staff, administration and the board is very complex indeed. It is not the same in all hospitals. I have been in a leadership position for decades and have witnessed the good, the bad and the ugly.
The ideal situation is where all parties have mutual respect for the roles of one another. Medical staff bylaws are essential to the medical staff self-governance and efficient interaction between the medical staff, the board and the administration. I believe it is absolutely essential that bylaws be adopted by the medical staff by a simple majority or two-thirds and be ratified by the board, where there usually is representation of the medical staff as well as the administration.
Once so ratified, any amendments must be made in a uniform manner, which should be detailed in the bylaws. Thus, if a member of the medical staff, the administration, the board, or a group wants the bylaws amended, a uniform procedure of forwarding the amendment to the executive committee for approval by a simple majority, submission to the medical staff for approval by two-thirds of the members at a duly constituted meeting, before being passed on to the board for final ratification. The board may adopt the amendment, suggest modifications/alternatives etc., or rarely, reject the amendment entirely. Trouble arises when any party seeks to ride roughshod over the others.
All parties must agree that no one entity can function without the others. Efficient, compassionate and cost-effective patient care is the paramount principle that should form the basis of any medical organization or hospital.
Pyara Chauhan, M.D.Attending urologistSt. John Health SystemSt. John Macomb-Oakland Hospital; vice chief of staff, Macomb CampusWarren, Mich.
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