Hospitals cannot carry out their missions without the participation and collaboration of physicians. Therefore, it is critical for board members and hospital executives to understand how they should relate organizationally to these critical players in the healthcare arena. Recent years have brought considerable controversy regarding the authority of hospital boards to encumber the so-called autonomy of the “organized, self-governing medical staff.” In an effort to empower the traditional medical staff organization to resist evolving trends in medical practice, physicians on The Joint Commission’s governing board in 2002 convinced that organization to propose significant changes to its medical staff standards. After more than half a decade of pushback and controversy, The Joint Commission may act this year to finalize its revised standards on medical staff governance.

In an illuminating white paper addressed to The Joint Commission, two distinguished healthcare attorneys—Brian Peters and Robin Locke Nagele from the firm of Post & Schell, P.C.—argue for a new paradigm in hospital–physician relationships around governance. They appeal to The Joint Commission to relinquish its support for the historic “American Model” of medical staff organization and governance, which they believe is inhibiting the movement for safer and higher quality healthcare institutions. Their sweeping monograph provides extensive history and context for their position and it is informative on the responsibilities and liabilities of hospital board members. Healthcare executives will find the detailed report provides them with the knowledge needed to be well-informed participants in the continuing debate over the proper role of doctors in hospital governance. While not every board member needs to read the full 77-page dissertation, the distribution of selected sections for information and discussion would be valuable contributions to board education.

Peters and Nagele have done the healthcare industry a great service in compiling this white paper. The full document is available by clicking on the Member Download link above. Regardless of your stand on the issues discussed, you’ll be a more informed participant in the controversy as a result.

— Todd Sagin, M.D., J.D., HG Healthcare Consultants