Here are some excerpts:
We believe that the primary barriers to reducing medical errors include the often dysfunctional relationships and communication gaps between hospital administrators and medical staff.
In order to address the poor relationship between hospital administrators and the medical staff, solutions must be behavioral, cultural and legal. Coming to grips with the challenge of non-payment requires cultural change of a fundamental nature. Indeed, it demands a return to the social and professional cohesiveness of the medical staff of a much earlier day.
However, that social and professional cohesiveness must be updated for the new economic, cultural, legal and political environment. This will require a joint effort of hospital administrators, medical staff leaders, lawyers and organizational development experts. Attorneys, for example, will be essential in crafting new models that protect organizational and professional rights while encouraging cooperation without violating restrictions on referrals, kickbacks and the like.
We believe an effective solution will, at a minimum, have the following five components:
-Reinvigorating the medical staff organization.
-Building relationships.
-Involving physicians in planning.
-Facilitating best practices.
-Assisting hospital departments in creating aligned surveillance and improvement mechanisms.
We may never return to the lamented (and perhaps apocryphal) days of yesteryear when hospitals and their medical staffs worked collegially, shoulder-to-shoulder, always in the best interests of patient care. However, knowledgeable hospital administrators and physicians will find it in their mutual best interests to take seriously the reimbursement proposals that threaten the status quo and use them to reverse the separation, independence and mistrust that have divided them. This will require a multifaceted effort ranging from building relationships and reinvigorating the medical staff to implementing best practices, sharing control, and improving management and operating systems.