Question

Changing Physician Credentialing, Dale Buchbinder

You are the Chairperson of the Department of Surgery and you attend the quality committee meetings. You do not have a vote on the quality committee because you need to carry out the recommendations of that committee. The committee is reviewing several cases of Dr. Monitor, one of the busiest surgeons on staff. These cases have had bad outcomes and the committee is concerned about Dr. Monitor’s surgical judgment. When each case is reviewed individually, it appears the issues are minor. However, upon detailed review of many of Dr. Monitor’s cases, a devastating pattern of events has emerged and the committee feels his practice patterns are not safe for the patients at this hospital. The committee has several choices; all choices are, however, only recommendations to you, the department Chairperson. The surgeon under scrutiny is not known to be arrogant or malicious and is, in fact, well liked. When you discuss these events with the partners in his practice, you find they are also concerned about Dr. Monitor’s practice patterns. You ask the committee to hold off on a recommendation giving you the opportunity to discuss the situation with the surgeon. After a very open discussion with Dr. Monitor and one of his partners, the Division Chief, you ask Dr. Monitor to voluntarily give up his privileges to perform the procedures that are in question. After being informed that he can only assist one of his partners in the procedures of concern, Dr. Monitor cordially agrees to comply with this recommendation. At the next quality committee meeting, you announce Dr. Monitor has volunteered to reduce his privileges.

Discussion Questions

1.    What are the facts in this situation?

2.    Dr. Monitor volunteered to reduce his privileges. Does this event constitute a disciplinary action? Is this required to be reported to the physician licensing board?

3.    What obligations, if any, does the Chairperson have to report this to other hospitals where Dr. Monitor has privileges?

4.    If Dr. Monitor had been a difficult personality to deal with, do you think the Chairperson of surgery would have proceeded in the same manner? What type of communications do you think might have occurred in that scenario? Provide your reflections and personal opinions as well as your rationale for your responses.

Answer 1

1. The facts in this situation are :-

- There is a sincere quality monitoring committee is present in the organisation to check the quality of practice rice of the healthcare staffs.

- The privileges and degrees are verified properly before and also during practice period if any negative feedback raises.

- The individual is called for a discussion with quality committee people to discuss on the issues.

2. Yes,this event constitute a disciplinary action because it's about the privilege which an individual gets after putting his all efforts in getting good marks in the professional exams . It's verified by the examination and education authority and then the license to work as a physician is given to them . Yes it is important to be reported the physician licensing board because they are the real authority to cancel the license of the physician based on their poor quality care services.

3. The chairperson has the responsibility to convey the information about the reduction of the privilege which is done on the bases of his less quality care to the other hospitals where Dr.Monitor Works to avoid any misconduct and harm to the patient's .

4 . No, it would not be easy to proceed in the same way because if Dr. Monitor was reluctant or had a difficult personality to deal with ,then the chairperson has to take the help of legal authority to delt with the situation . There must be informal kind of communication between them in which no solution of the problem is attained.