Tips for improving medical staff and hospital board relations

In hospitals all across the country, the board of trustees is fiscally responsible for the financial wellbeing of the organization. The governing board is also ultimately responsible for the credentialing and privileging of all practitioners in the organization and for monitoring the quality of care these practitioners provide. However, because the board lacks the expertise to credential and privilege and monitor the quality of care, these tasks are often delegated to the organized medical staff. Unfortunately, some medical staffs and boards do not have a good working relationship.

Some medical staffs view certain board decisions as "physician unfriendly." In years past, the goals of physicians and hospitals were more aligned. Today, we are in an era of both cooperation and competition leading to so-called "coopetition." To survive, the medical staff and the board must break down any barriers between them and develop a culture of good relations.

Changing your hospital's culture doesn't occur overnight. It takes constant effort and begins with small steps, including the following:

• Cross-pollinate your meetings. Invite different medical executive committee (MEC) members to governing board meetings on a rotating monthly basis and place physicians on certain board committees. Reciprocate in like fashion by inviting a different governing board member to MEC meetings monthly and placing board members on the credentials and quality committees.
• Have an annual, full-day MEC—governing board strategic planning session to exchange ideas and set priorities and goals for the year.
• Try to create as many opportunities for informal gatherings as possible. Whether it is quarterly events at someone's home or gatherings at public places, these casual events allow both the board and medical staff to see each other in a different light. Getting to know each other personally and socially goes a long way when you have to work together on difficult issues later.
• Consider attending joint educational sessions together. Several organizations have excellent meetings that appeal to the board, MEC, and administration. Sending a group of  physicians, board members, and administration together to these meetings tends to build camaraderie. You may also want to consider arranging for an onsite half- to full-day seminar on topics tailored to your exact needs.

Using these strategies over several years on an ongoing basis will not only create goodwill, but will also create mutual respect, understanding, and an ability to work together into the future.