Small Hospital Challenges Monthly: Medical staff leadership challenges

Dear Medical Staff Leader,

Years ago, when medical staff leadership was primarily honorary (and not the hard work it is today), there was little difficulty getting people to serve in these roles. But times have changed—the role has become increasingly complex now that medical staff leaders must address their fellow staff members’ clinical and behavioral performance. In addition, the time commitment required of medical staff leaders has increased commensurate with the added responsibilities.

If that wasn’t enough, small hospitals typically have small medical staffs, which creates a limited pool of leadership candidates. Due to the budgetary constraints many small-hospital medical staffs face, many cannot afford to properly train their leadership. However, small-hospital leaders need to receive a broad education because not as many committees support the MEC, meaning medical staff leaders need to juggle varied responsibilities. Even if a hospital has the funds to support appropriate medical staff leadership training, the physicians in these positions may not have the time or the coverage to attend all the meetings they would like.

The most difficult part of being a medical staff leader in a small community is that all medical staff members know each other well and share patients. This may make discussions with fellow physicians regarding clinical performance or behavior even more difficult. The medical staff leader may not want to alienate another physician who may be a major referral source, especially in a community with a limited referral base. This alone may discourage many physicians from becoming leaders.

How do medical staffs in small communities overcome these challenges? Educating future and present medical staff leaders is paramount. They need to know a broad range of material (credentialing, peer review, conflict resolution, etc.), and they need to learn the art of conducting collegial interventions with fellow physicians without becoming alienated by them. Even more so, medical staff leaders need to pass their knowledge down to the medical staff so that each member understands what is needed in today’s performance-driven environment. With this understanding, medical staff members can strive to do the right thing rather than be forced to do so by their leaders.

Medical staff leaders should receive periodic education, whether off-site or on-site, every couple of years. In the interim, leaders can take advantage of other educational resources such as Web conferences, audio conferences, and printed material. This will allow leaders to sharpen their leadership skills and learn best practices. And don’t forgot that past leaders may be great sources of information and provide mentorship.

Best,
Mary Hoppa, MD, MBA, CMSL
Senior Consultant
The Greeley Company