Medical staff effectiveness: Fifth in a series

Dear Medical Staff Leader,

I recently spoke with a chief of staff who was challenged by the hospital board to improve physician meeting attendance at meetings. Physician attendance at the hospital's department, committee, and medical staff meetings has seriously declined-as is the case in many hospitals across the country--sometimes with less than 10% of members attending. The decline in physician attendance can be attributed to the many important and competing demands on physicians' time, but it is a dangerous problem that must be solved.

When physicians fail to participate in their democratically-organized medical staff, some or all key medical staff functions will eventually be taken over by hospital managers and paid medical directors---dramatically decreasing physician influence and hastening the decline of the organized medical staff.

In fact, some medical staff insiders link the decline in medical staff meeting attendance to the Joint Commission on Accreditation of Health Care Organizations' (JCAHO's) elimination of a mandatory meeting attendance requirement. Prior to that change, physicians' memberships were rarely revoked solely for poor meeting attendance even though few medical staffs enforced attendance requirement. It seems that the JCAHO standard encouraged medical staff meeting attendance on its own.

Is reintroducing mandatory meeting attendance the answer to today's declining attendance? Some medical staffs have taken this approach and seen a modest increase in physician meeting participation. However, this approach misses a deeper issue that medical staffs must tackle, which is that physicians do not attend meetings because they don't deem these meeting valuable when compared with other demands.

Physician leaders should keep in mind that the primary reason for such meetings is to encourage communication with and among the medical staff-a task made simpler with modern technology by providing multiple avenues for communication. Medical staffs now use fax, email, Web sites, electronic bulletin boards, chat rooms, and virtual meetings to ease communication.

Before you reintroduce mandatory meeting attendance, think about today's realities and determine whether a coordinated, modern medical staff communication plan can accomplish your goals in a way that best respects physicians' time and priorities.

That's all for this week.

All the best,

Rick Sheff, MD