Connecting the Dots
Sometimes a child’s game can be used to dissect and understand complex and important issues. Connecting the dots is just such a game. Questionable patient care is just such an issue.
How might one connect the dots regarding questionable patient care?
Begin at dot #1 by recognizing there are three systems with the potential to review questionable patient care:
State medical examining boards – basically of little value
Medical malpractice litigation – a legalistic nightmare
Medical peer review – like fog, it is known to exist, but due to legislative-created secrecy, its value is intangible
How then might an interested party prove the value of the nebulous system of medical peer review?
Connect dot #1 with dot #2 and review:
The Joint Commission Manual Credentialing and Privileging Your Medical Staff, 2007 Responsibilities of the Hospital.
Applicable Joint Commission Standards: Standard MS.4.20.
Elements of Performance for MS.4.20 “The governing body or delegated governing body committee has final authority for granting, renewing or denying privileges.”
Draw a line to dot #3:
Procedures for appointing and replacing outgoing members of hospital boards of directors/trustees will vary from state to state, but that process will periodically occur at all hospitals.
Continue to dot #4:
Conduct a very simple test in any community containing one or more hospitals. Hospital trustees/directors usually are among the most highly respected members of their community.
Proceed to dot #5
Assemble as many past hospital trustees/directors as possible. Hospital trustees/directors command the final step regarding the viability of any hospital medical staff peer review system.
Dot #6:
Ask them to provide, in general terms and without specific doctor’s names, their past experience in granting, renewing and most importantly, denying hospital medical staff privileges (medical peer review). Past hospital trustees/directors, freed of immediate formal responsibility and declining to name names, are the best source in determining if medical peer review regarding questionable patient care is a local myth or a professional reality.
dot #7
Another untapped reservoir of information might well be obtained from retired and semi-retired physicians. There are far more senior practitioners who are exceedingly unhappy with the current stature of their profession and those who could, if lead to, describe the truth from inside the medical profession.
The final dot:
This untapped reservoir of information gleaned from a group of respected community leaders could prove to be invaluable, particularly if several communities in the same state ran similar inquiries.
The entire picture emerges:
The only way to separate myth from reality is to seek to identify existence of the reality, or to be prepared to find the myth is the reality. Unfortunately, the time-honored tradition clearly demonstrates the woe which becomes those who break the code of silence.
Hopefully, the current need for positive healthcare change can lead such troubled souls to help clarify the many defects within the medical profession and help create a renewed profession for all concerned.