The organized medical staff and the road to Oz
Like other great allegories, Baum’s classic “The Wizard of Oz” is more than a story of a young girl who is deposited in the faraway land of Oz and beings her search for the Wizard help her to find a way home. Along the way, she meets characters that she does not recognize as people from her everyday life in Kansas and battles monkeys and witches that are no more than the everyday conflicts that she has run away from. She is able to go home only when she takes personal responsibility for her own power and acknowledges that everything she has encountered in Oz will be at home waiting for her.
Like Dorothy, the organized medical staff has far more power than it realizes. It controls all of the hospital’s operating revenue, most of its costs, and has an enormous affect on the hospital’s ability to succeed or fail. Also like Dorothy, it tends to ascribe unusual powers to leaders within the management team and the board, most of whom generate no revenue and depend on the dedication and commitment of the organized medical staff for their own professional and organizational survival. The medical staff sometimes loses its way and engages in battle with winged monkeys or witches over old but recurring conflicts or issues having to do with an external environment that is seldom, if ever, under any one person’s control.
The road to Oz is not easy because it requires medical staff members to accept personal responsibility for how they react to the multiple forces within healthcare that they may not have control over. As physicians, we control our clinical decisions and our personal interactions with patients. As an organized medical staff, we control the governance of the medical staff and the key functions of credentialing, privileging, and peer review. We can assure that we perform credentialing and privileging with due diligence while balancing patient safety with the need to support physicians. We can perform peer review in a manner that is fair, transparent, and constructive while advocating for both practitioners and the patients they serve. We can govern the medical staff wisely while serving both the needs of individual practitioners and the hospital through our accountability to the governing board. By doing so, we can optimally increase our influence on our local environment and establish credibility for the quality work that we do.
We can reach home safely if we understand what aspects of healthcare we can manage and control and respect those whose roles complement our own. We can partner with management and the board to secure a better future for our community, enhance patient safety while advocating for the members of the medical staff we represent, reduce unnecessary paper work and redundant care while focusing on providing cost effective care and services, and leave a legacy of healing and commitment that reflects upon the best values of our profession and of ourselves
Thus, if we focus on the richness of the healing arts and create a medical practice and an organized medical staff of integrity and value, then the Emerald City is ours for the taking and the journey home will not be long behind.
Wishing you continued success.
Jon Burroughs, MD, MBA, FACPE, CMSL, is a senior consultant with The Greeley Company, a division of HCPro, Inc. in Marblehead, MA.