Developing intended practice plans

In today’s difficult healthcare environment, there is no immediate advantage to appointing a physician to a medical staff unless that physician will help the institution and medical staff fulfill their patient care and community service obligations. Thus, before granting a physician medical staff membership and privileges, it is appropriate to ask that physician how he or she intends to practice.

Under an intended practice plan model, part of the application process involves asking a physician what he or she plans to do in his or her practices during the next two years. This can be accomplished using a form in the application package. The form should consist of a series of questions, including:

• Where will you practice?
• To which hospitals will you admit and refer your patients who require hospitalization?
• Will you admit your own patients to our hospital?
• Will you refer patients to our hospitalist program?
• Will you perform consultations for hospitalized patients, if requested?
• Will you participate in our ED call program?
• Of the insurance programs the hospital participates in, which will you accept?
• The following communities have been designated as areas of physician need. In which of these areas, if any, will you be practicing?
• Will you participate in meetings and activities of the organized medical staff?
• Are you willing to serve in a leadership position on the organized medical staff?

When crafting these questions, it is important to focus on how physicians will help the hospital fulfill its mission. However, avoid linking physicians’ medical staff membership or privileges to admission or referral volumes. Doing so could violate Stark and anti-kickback requirements. Questions regarding the physician’s financial interests in competing entities and how the physician intends to balance these interests with your hospital’s mission and vision may be part of the form, but such questions must be carefully worded, again, to avoid violating Stark and anti-kickback requirements.

 This excerpt is from The Greeley Guide to New Medical Staff Models: Solutions for Changing Physician-Hospital Relations by Richard A. Sheff, MD, CMSL, and William K. Cors, MD, MMM, FACPE, CMSL.