A medical staff leader's guide to change management

The medical executive committee (MEC) at Better Times Hospital has proportional representation. Many years ago (no one is sure exactly when), the MEC agreed that each of the 15 clinical departments should have at least one seat on the MEC regardless of its size. For every additional 50 members, each department would have another seat on the MEC. The department of medicine, with 210 members, has four MEC seats. The 15 cardiologists in the department of medicine feel they have little in common with the rest of the department. They are anxious to join a proposed cardiovascular and endovascular service line with cardiac surgeons, vascular surgeons, and interventional radiologists. The chair of the department of medicine is adamantly opposed to this because it would reduce the department's membership to fewer than 200 and result in the loss of a MEC seat.

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