Before deciding whether to accept a unified, system-wide medical staff, the medical staff should carefully weigh the potential costs and benefits of this decision.
The following checklists are presented as a starting point for medical staff discussions regarding unification and disunification.
Because circumstances vary widely across hospitals and systems, these checklists may not comprehensively address the circumstances of every medical staff.
Issues to consider before your medical staff votes to become part of a unified, system-wide medical staff
Potential costs of unification
- Reduction of medical staff connection with or representation on the governing body
- Disenfranchisement of smaller medical staffs with smaller ratio of members
- Loss of community standards
- Loss of hospital-specific services
- Loss of influence over medical staff bylaws, rules and regulations, and policies
- No recognition of variances in staffing, equipment in support of medical practice between hospitals
- State law peer review protection may not apply
- System-wide obligations, such as ER call
- Imposition of system bylaws that may not be physician-friendly
- Unified medical staff subject to a potentially disruptive disunification vote at any time
Potential benefits of unification
- Larger medical staff organization can form a stronger organization
- Avoid conflicts of interests, local politics
- Clinical standards developed across greater numbers of peers, patients
- Access to system-wide contracting, education opportunities
- Eliminate discrepancies across system bylaws
- Reduce redundancy across hospitals/medical staffs
- Protection of better peer review protections under other state’s laws
- Consolidation of duties, obligations
Issues to consider before your medical staff votes to opt out of a previously unified, system-wide medical staff
Potential costs of disunification
- Loss of system contracts, education opportunities
- Loss of state peer review protections applicable to unified staff
- Access to broader clinical resources
- Return to local politics
- Bylaws will require amendment to reflect different medical staff structure
Potential benefits of disunification
- Restoration to status quo before unification
- Return to state peer review protections
- More direct relationship with Governing Body
- Greater medical staff self-governance
- Bylaws may be restored to pre-unification bylaws
Visit the AMA's website for additional resources for organized medical staffs.
Content courtesy of the American Medical Association
