Economic Credentialing

HA4070D – Regulatory Environment in Health Care

Assignment 09.1: Economic Credentialing

Directions

Complete the Problem beginning on page 463 of your text titled “Problem: Economic Credentialing” in a one to two page paper. Submit the completed assignment to your instructor. See page 369 for a general description of Marcus Welby Hospital.

You are the lawyer for Marcus Welby Community Hospital. The administrator approaches you about how to amend the bylaws so that the hospital can get rid of doctors who are costing the hospital too much money under Medicare and HMO insurance. The administrator is concerned about which removal actions can be defended in court and which bylaw amendments are politically feasible with physicians. Advise the administrator on each of these options:

• Amend the Hospital Bylaws to give the hospital board authority to remove doctors from the medical staff for any reason, regardless of the medical staff’s own recommendations, as long as the medical staff is first consulted.

• Amend the Medical Staff Bylaws to declare that an additional criterion for medical staff membership is to practice an efficient style of medicine that avoids wasting medical resources or providing unnecessary care.

• Forget about amending any bylaws. Instead, go after physicians who are economic losers based on their general medical competence and their unwillingness to be cooperative.

• Keep but supplant the entire medical staff structure by limiting who can practice in each department through one-year renewable contracts with the 200 best doctors out of the present 300.

Note that the assignment asks you to comment on each of the options, not just one. You may comment on one option being better than another for some reason, but be sure to comment on all the options. Support your advice with material from the text.

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