This I Believe…
Proposal for a Revision in The William W.
Backus Hospital Medical Staff Bylaws
Dennis Slater, MD
Not long ago there were two clinical administrators
that supervised the conduct of The William W. Backus
Hospital physicians: the Chief of Clinical Services and
the Medical Director. The administrative bureaucracy
has grown and a host of clinical administrators are
supervising physicians: the Medical Director, the Director
of Quality and Safety, the Director of the Intensive Care
Unit, the Director of Cancer Services, the Vice President of
Medical Affairs, and the Hospital President, to name a few.
In 2016 the hospital administration established a new
position – the Chief of Medicine. This was a part-time
salaried position, similar to the Chief of Surgery, with a
lengthy list of responsibilities and notably elevated above
the “chiefs” of the various divisions within medicine and
surgery. The Medical Executive Committee requested,
and the hospital agreed, to an ad hoc committee of
physicians in the Department of Medicine to interview
candidates and make formal written recommendations.
After the administration selected their favorite candidate,
the Medical Executive Committee was asked for a vote
of approval.
The process of including the medical staff through its
representative organ, the Medical Executive Committee,
in selecting administrative leaders affords legitimacy to
leadership. The exact process may vary with the specific
position, but some process requiring input and a vote
of confidence by the Medical Executive Committee is
crucial. Presently none of our administrative leaders
except for the aforementioned Chief of Medicine and the
Hospital President (consenting post ad hoc to an interview
and vote by the MEC!) has had a vote of support from
the Medical Executive Committee.
Therefore, I propose a revision of the hospital bylaws
4.B., 4.B.2(b), 4.B.3(c) detailed below. The revision was
discussed at the Medical Executive Committee meeting
on October 2nd, 2017, and again on February 5th, 2018.
The Medical Executive Committee voted for approval of
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the bylaw revision on February 5th, 2018, which then will
be presented to the medical staff at the quarterly staff
meeting for debate and a final vote.
Current bylaw 4.B. Selection of Department Chiefs.
Proposed change in bylaw 4.B. Selection of
Department Chiefs and Directorships
Current bylaw 4.B.2(b) When a vacancy arises in
a contracted position, the hospital administration, in
consultation with the medical executive committee, will
propose a process to select the department chief. Such a
process may include a search committee appointed by the
president of the medical staff, VPMA, and the hospital
president.
Proposed change in bylaw 4.B.2(b) When a vacancy
arises in a contracted position, the hospital administration,
in consultation with the medical executive committee, will
propose a process to select the department chief, medical
director, medical director of quality and safety, medical
director of the intensive care unit, medical director of
cancer services, and medical director of the palliative care
team. Such as process may include a search committee
appointed by the president of the medical staff, the
VPMA, and the hospital president.
Current bylaw 4.B.3(c) In the case of a contracted
department chief position, the members of the
department may hold a vote of no confidence, but
removal may only be effectuated by the board, with input
from the hospital medical staff leadership, in accordance
with the terms of his or her contract.
Proposed change in bylaw 4.B.3(c) In the case of
a contracted department chief or medical directorship,
the members of the relevant department or the medical
staff may hold a vote of no confidence, but removal may
only be affected by the board, with input from the hospital
medical staff leadership, in accordance with the terms of
his or her contract. g
O P E N JO URNAL • W I NTE R 2018