Choosing appropriate hearing panel members: Don't shoot in the dark
A Medical Staff Leader Connection reader recently asked who can serve on a hearing panel and whether the practitioner requesting the hearing has any input on the selection of these hearing panel members. When answering this question, medical staff leaders need to consider what is fair to all parties involved.
First, it is the medical staff’s and hospital’s responsibility to appoint the members of a hearing panel. There are some well established restrictions that preclude certain individuals from being appointed to a hearing panel for an individual case. For example, the medical staff and hospital should not appoint an individual to the hearing panel who is a direct financial competitor or partner of the physician in question, as doing so poses a conflict of interest.
The practitioner undergoing a hearing should have the ability to object to any hearing panel member because he or she may know of a conflict of interest that may not be apparent to medical staff and hospital leaders. Those leaders should take the objection and the reason for it into consideration, but they are not mandated to remove a panel member due to an objection. The medical staff and hospital truly have full and final authority regarding who is appointed to the hearing panel.
Also, there should be a timeframe within which the involved practitioner may make an objection. This allows adequate time for medical staff and hospital leaders to consider the objection. If leaders decide that the objection is valid, they would then have adequate time to appoint a replacement panel member and ensure timely commencement of the hearing. Objections should not be used as a tactic to delay the hearing from occurring.
The following is some model language that that you can use regarding the appointment of a fair hearing panel.
Hearing Panel
a. When a hearing is requested, a hearing panel of no fewer than three individuals will be appointed. This panel will be appointed by a joint decision of the CEO and the president of the medical staff. No individual appointed to the hearing panel shall have actively participated in the consideration of the matter involved at any previous level. However, mere knowledge of the matter involved shall not preclude any individual from serving as a member of the hearing panel. Employment by, or a contract with, the hospital or an affiliate shall not preclude any individual from serving on the hearing panel. Hearing panel members need not be members of the hospital medical staff. When the issue before the panel is a question of clinical competence, all panel members shall be clinical practitioners. Panel members need not be clinicians in the same specialty as the member requesting the hearing.
b. The hearing panel shall not include any individual who is in direct economic competition with the affected practitioner or any such individual who is professionally associated with or related to the affected practitioner. This restriction on appointment shall include any individual designated as the chair or the presiding officer.
c. The CEO or designee shall notify the practitioner requesting the hearing of the names of the panel members and the date by which the practitioner must object, if at all, to appointment of any member(s). Any objection to any member of the hearing panel or to the hearing officer or presiding officer shall be made in writing to the CEO, who, in conjunction with the president of the medical staff, shall determine whether a replacement panel member should be identified. Although the practitioner who is the subject of the hearing may object to a panel member, he or she is not entitled to veto that member's participation. Final authority to appoint panel members will rest with the CEO and the president of the medical staff.
Mary Hoppa, MD, MBA, CMSL, is a senior consultant with The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.