QUESTIONS TO QUESTIONS TO DEBATEDEBATE

Chapter 6, Instructor’s ManualChapter 6, Instructor’s Manual

1. The traditional model of hospital privileges The traditional model of hospital privileges and fee-for-service practice can be described and fee-for-service practice can be described as a partnership, a sharing of responsibility as a partnership, a sharing of responsibility between the physicians and the institution. between the physicians and the institution. What does each partner contribute, and what What does each partner contribute, and what do they expect to get from it? How is this do they expect to get from it? How is this changing at the beginning of the twenty-first changing at the beginning of the twenty-first century?century?

© 2006 by John R. Griffith and Kenneth R. White

2. The emergence of service lines tightened the The emergence of service lines tightened the bonds between physicians in similar bonds between physicians in similar specialties and their accountability to the specialties and their accountability to the governing board. The service lines contracts governing board. The service lines contracts often include employment, risk sharing, and often include employment, risk sharing, and joint capital investment arrangements that go joint capital investment arrangements that go well beyond the traditional privileging. Why well beyond the traditional privileging. Why might this be a positive development? What might this be a positive development? What are some alternatives, and where will the are some alternatives, and where will the relationships go in the future?relationships go in the future?

© 2006 by John R. Griffith and Kenneth R. White

3. Many primary care physicians claim Many primary care physicians claim that they no longer need medical staff that they no longer need medical staff membership or hospital privileges to membership or hospital privileges to take care of their patients. They feel it take care of their patients. They feel it is an inefficient drain on their time, and is an inefficient drain on their time, and it is difficult for them financially. it is difficult for them financially. Should the hospital ignore their Should the hospital ignore their concerns and let them drift off from the concerns and let them drift off from the organization? If not, what should the organization? If not, what should the hospital do to make affiliation hospital do to make affiliation attractive?attractive?

© 2006 by John R. Griffith and Kenneth R. White

4. Some physician organizations elect Some physician organizations elect leaders. Management may hire a CMO. leaders. Management may hire a CMO.

What is the relationship between the What is the relationship between the elected leaders and the CMO? Can the elected leaders and the CMO? Can the CMO represent the interests of CMO represent the interests of management and the physician management and the physician organization at the same time?organization at the same time?

© 2006 by John R. Griffith and Kenneth R. White

5. Some flash points in physician relations are Some flash points in physician relations are recurring and predictable. How would a well-recurring and predictable. How would a well-managed organization deal with the following:managed organization deal with the following:

• Interspecialty disputes: orthopedics and imaging, Interspecialty disputes: orthopedics and imaging, surgery and anesthesia, primary care and surgery and anesthesia, primary care and specialists?specialists?

• Emergency referrals: providing specialist care to Emergency referrals: providing specialist care to emergency patients, who often arrive at emergency patients, who often arrive at inconvenient times and without insurance or inconvenient times and without insurance or financing?financing?

• Multispecialty group versus single specialty Multispecialty group versus single specialty groups?groups?

• Impaired physicians?Impaired physicians? © 2006 by John R. Griffith and Kenneth R. White