Read through the posts submitted by your fellow students. Come to your own conclusion about insurance carriers. In your opinion, are insurance companies unfair to hospitals? Are they in it solely for

Read through the posts submitted by your fellow students. Come to your own conclusion about insurance carriers. In your opinion, are insurance companies unfair to hospitals? Are they in it solely for financial gain? What about the hospitals, are they being competent and thorough? Provide as much information as you can regarding your opinion on hospital liability for incompetent doctors and the insurance industry. For this post, cite to a fellow student’s post as support for your position.

  • The accuracy of your cites (citations are mandatory)
  • Your writing skills (grammar / spelling)
  • Proper word count (between 150 – 250 words ONLY)

As a hospital administrator I am the liaison between the medical staff and the organization’s governing body and management.  It is important for me to know and understand the organizations mission, vision, goals and culture for serving the community and its patients, based on this information I should select providers that have work ethics and vision that align with these aspirations.  The first step in hiring the appropriate physician is to provide an extensively detailed job descriptions for the available positions, and seek the best candidate through the following steps:

  • Application—The candidate must provide details of medical school education, internship, residency program, license to practice medicine, board certification, fellowship, medical society membership, malpractice coverage, unique skills and talents, privileges requested and specialty, availability to provide on-call emergency department coverage where applicable, availability to serve on medical staff and/or organization committees, medical staff appointments and privileges at other healthcare organizations, disciplinary actions against the applicant, unexplained breaks in work history, voluntary and/or involuntary limitations or relinquishment of staff privileges, and geographic requirements (Pozger, 2019, p. 222).      
  • Medical Staff Bylaws—All applicants for medical staff privileges are required to sign a statement attesting to the fact that the medical staff bylaws have been read and understood and that the physician agrees to abide by the bylaws and other policies and procedures that may be adopted by the organizations medical executive committee and governing body (Pozger, 2019, p. 222).      
  • Physical and Mental Status—An applicant’s physical and mental status should be addressed prior to the granting of medical appointments and staff privileges (Pozger, 2019, p. 222).      
  • Consent for Release of Information—Consent for release of information from third parties is obtained from the applicant.  References from a minimum of three past employers providing details of experience, work ethic, and work history are required (Pozger, 2019, p. 222).      
  • Certificate of Insurance—The applicant must provide evidence of professional liability insurance that meets or exceeds insurance coverage limits determined by the organization (Pozger, 2019, p. 222).      
  • State Licensure—A physician’s right to practice medicine is subject to the licensing laws contained in the statures of the state in which the physician resides.  The right to practice medicine is not a vested right, but a condition of a subordinate to the police power of the state to protect and reserve public health.  A candidate must provide proof of State licensure, board-certification, and medical school and residency completion (Torrey, 2019).
  • National Practitioner Data Bank—Healthcare organizations much query the National Practitioner Data Bank for information on applicants seeking medical staff privileges and every two years on the renewal of appointments as a comprehensive review of professional credentials.  The Federation of State Medical Boards (FSMB) site is used to obtain a list of any actions related to medical malpractice of applicants (Torrey, 2019).
  • References—A thorough background and reference check is conducted including both written and oral references are obtained from previous organizations the applicant has been affiliated with specifically investigating the qualifications and limitations of the attending physician during employment.  Word of mouth and social media sources also provide information about the applicants’ personality and attitudes (Torrey, 2019).
  • Interview Process—This is a very lengthy process of panel interviews with management, the governing body, the medical executive committee, and a peer review.  The process of the interview is to ensure that all documents have been completed; breaks or gaps in education or employment are accounted for; a thorough investigation checking for any disciplinary action or misconduct investigations or any pending investigations; any license suspensions, limits, denials, revokes, or refusals; has the applicant ever withdrawn an application or resigned to avoid disciplinary action; has the applicant ever been named as a defendant in a lawsuit or criminal proceeding; does the applicant agree to abide by the medical staff bylaws, rules, and regulations; is the applicant a team player; any restrictions from participating with any health insurance programs; checking malpractice insurance coverage history for terminations by action of insurance carrier; and does the applicant have any physical or mental impairments that could affect his or her ability to practice (Pozger, 2019, p. 223).      
  • Delineation of Clinical Privileges—Medical staff determines what procedures a physician is authorized to perform based on predetermined criteria as to what credentials are necessary to competently perform the requested, including education and supervised practice to verify the skills necessary to perform the privileges being requested.
  • Governing Body Responsibility—The governing body has the duty, responsibility, and authority to select the organization’s professional staff and ensure that applicants are qualified to perform the clinical privileges requested (Pozger, 2019, p. 224).      
  • Appeal Process—An appeals process described in the medical staff bylaws covers issues of denial of professional staff privileges, grievances, and disciplinary actions.  The governing body reserves the right to hear any appeals and be the final decision maker within the organization (Pozger, 2019, p. 224).      
  • Reappointments—Each physicians’ credentials and departmental evaluations are reviewed at a minimum of every two years with effective mechanisms in place for monitoring and evaluating the quality of patient care and the clinical performance of the physicians (Pozger, 2019, p. 224).      

            These processes are reviewed and updated on a minimum of an annual basis for improvement.

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