Physicians can take for granted or underplay the importance of Medical Staff Bylaws in hospital operations. The experiences of two NCMS physician members demonstrates the value of good medical staff bylaws as more physicians are being employed by hospitals.

“Physicians may find it’s not much fun in dealing with medical staff bylaws, but they are your bill of rights to deal with hospital administration,” said Shannon Hunter, MD, an otolaryngologist who practices in Clyde, NC.

Dr. Hunter was chief of staff when physicians at Haywood Regional Medical Center (HRMC) learned the hospital had lost its Medicare certification in early 2008, causing the 190-bed facility to temporarily lose Medicare and Medicaid payments. While physicians had tried to address concerns with hospital administration for several months, they were not informed about the looming crisis that led to decertification. As the news quickly spread throughout the western North Carolina community, physicians scrambled to find alternatives to help their patients while the hospital evaluated its management and operations.

As the hospital worked to regain Medicare certification, Dr. Hunter and her colleagues began working on getting physicians more involved and having a greater voice in hospital affairs. During the recertification process, she recalls that many patches had to be made to an antiquated set of bylaws, “but it was clear that an overhaul of the entire document was necessary when we were out of our reactionary phase to regain certification.”

“We wanted honest guidance and to build trust,” Dr. Hunter said. “We wanted to make sure we had bylaws that were friendly for the medical staff—not just the administration.” She contacted the North Carolina Medical Society for assistance.

 “We looked to NCMS for guidance. NCMS made recommendations that helped us meet guidelines. This included hiring an outside attorney to review what we had developed. The process went very well and helped to build the level trust we wanted,” she said.

Today, HRMC is part of the Charlotte-based Carolinas Healthcare System. In reflecting on her experience, Dr. Hunter stressed the importance of reviewing medical staff bylaws to ensure that physicians have a strong voice in hospital management and operations.

“It’s important for medical staff to meet regularly. Some may not see the need for medical staff bylaws, but they must understand that bylaws protect doctors. With good bylaws in place, physicians can better respond to changes in rules and laws and make adjustments in the ever-changing medical environment,” Dr. Hunter said.

“Today, we have a comfortable relationship between the medical staff and hospital administration,” said Robin Matthews, MD, an obstetrician/gynecologist in Waynesville, NC, who continues to chair the committee that reviewed and revised the Medical Staff Bylaws as the hospital regained certification and underwent administrative changes.

“Dr. Matthews and the Bylaws Committee are to be commended for the completion of our revision,“ Dr. Hunter said. “They were constructed by the medical staff for the medical staff and reflect our commitment to stay involved in our own self-governance.”

Currently, the Bylaws Committee is working on rewriting the Rules and Regulations. Dr. Matthews describes medical staff relations as very healthy, with physicians asking questions, seeking accountability and avoiding complacency.

To keep the medical staff engaged, Dr. Matthews believes physicians need to:

• Meet regularly
• Stay involved
• Be aware of necessary changes and avoid resisting those changes
• Be assertive and engaged.

The NCMS encourages physicians to regularly review their medical staff bylaws and make changes to maintain a strong voice and ensure quality care for their patients. For assistance, please contact Melanie Phelps at [email protected] or 919-833-3836.

Links to Helpful Resources:

Physician-Hospital Resource Area

Model Medical Staff Bylaws (Members Only)

Related stories:

Are Your Medical Staff Bylaws in Compliance? (Bulletin, 1-14-11)

Revised Model NCMS Medical Staff Bylaws Now Available (Bulletin, 1-7-11)