Problem Resolution - Dr Clark - Essay Example

Introduction The facts of the case relates to the ity of the non-profit hospital administrator operated by the to approve the Chief of medical staff’s proposal (Dr. Clark) to cancel the privileges and credentials and even the termination of a physician, employed by an employment contract, in the hospital cited. Dr. Clark’s main reason was the possibility that medical staff bonuses would likely suffer but then offered some files which would help make the decision easier. As an administrator, your decision would certainly have important implications. This paper then would identify the issues of the scenario given, a discussion of the importance of such issues and finally, the possible resolution to the issues raised. Issues The first important issue to be answered is whether the position of an administrator has indeed the authority to approve any cancellation of privileges and credentials of a medical staff including that of physicians and the authority to approve their termination from employment. On a side issue which must also be determined but however must be answered primarily by Dr. Clark, is whether a chief of the medical staff has the authority to cancel privileges and credentials of a medical staff and to terminate them from employment of the hospital. These issues are important since the Dr. Clark’s proposed action is premised on his claim that he has the power to cancel Dr. Kirk’s privileges and credentials and also the power to terminate him. Dr. Clark also claims that this proposed action could be done if there is approval from the administrator which is given such great weight. Hence, an examination of applicable laws, rules and regulations including an examination of the hospital handbook or policy is important to answer this issue. The second issue is on the validity of the employment contracts which serve the basis for any physician’s employment. In the cited scenario, physicians are employed by means of employment contracts. Its validity serves as a basis for either party in defending a discharge or termination of a medical staff or the basis for a claim on the part of the medical staff claimant (Shepard, 2007). Hence, it must be determined whether the employment contract is in accordance with the Constitution, applicable laws, statutes, policies, rules and regulations governing employment in healthcare organization, to be considered as a valid contract. Otherwise, the contract may be declared void for being against the Constitution or against the applicable law, rule, regulation or hospital policy, and may not be used by either parties for their respective claims and defenses. Other relevant laws, rules and regulations would then apply. If there is a valid employment contract between the parties, the next important issue to determine is the terms stated in the contract, whether it contains a tenure provision requiring cause or causes for a physician’s termination and the procedure to be adopted in case of termination. Employment contracts are binding agreements between parties. Said contract would therefore identify whether a physician may be terminated with or without cause and what procedure to adopt for the termination of any a medical staff or of a physician for that matter. Hence, if the employment contract states that a physician may be terminated with cause, an administrator then should have a cause for his termination. If on the other hand, said employment contract states that a physician may be terminated without cause, then a hospital can easily terminate a physician’s services even without any cause. The procedure to be followed in cases of termination is also important since it will be the basis on whether there was due process in the termination of any medical staff. The procedure may contain the evidence required which is used as the basis of termination, the approval required for a physician’s termination and the required notice of termination. If the procedure were followed then the hospital would not have a problem in a physician’s termination. On the other hand, if there was a procedural lapse on the part of the hospital, then this may be a basis for action on the part of the physician terminated. Another issue related to the terms of the employment contract, is whether there is a required covenant of good faith and fair dealing. This issue is important since, the intention of either party in the fulfillment of the any duties and obligations based on the said contract may be determined especially if in case of termination and cancellation of employment, and the possible claim of physicians or medical staff based on contract. The last important issue is whether the cancellation of privileges and credentials of Dr. Kirk would be consistent with the Constitution or applicable laws, rules and regulations. One of the proposals made by Dr. Clark in addition to the termination of Dr. Kirk’s employment is also the cancellation of privileges and credentials. This must then be determined in order to ensure that there is basis for the decision made by the administrator in case of approval of the said cancellation in case of any suit that may be filed against them. Resolution If I were an administrator of the hospital, I would first ensure that it is explicit in the hospital handbook and under applicable laws, rules and regulations, that I have the authority to approve the termination of employment of the medical staff and cancellation of any privileges previously accorded. It must be ensured that the said approval is within the scope of my authority as eventually I would be held accountable for any future suits or claims that may be made by any medical staff. If this authority is established, I would then look into the basis of the proposed action of Dr. Clark by examining both the employment contract and the files which Dr. Clark submitted relating to the work efficiency of Dr. Kirk. If the employment contract contains a provision that a medical staff should be terminated with cause, I would then check the files and records submitted if indeed there is sufficient basis for his termination. And if there is a sufficient basis for his termination based on the records, then I would approve the proposed action. On the other hand, if there is no basis or insufficient basis for the termination of Dr. Kirk’s employment, I would then have to disapprove the proposed action of Dr. Clark. In case there is no required cause or that a physician may be terminated without cause, then I can easily approve the proposed action. In a number of case laws both federal and state case laws, termination may be justified on a case to case basis depending on the evidence presented hence, for my approval to be justified there must be sufficient basis for Dr. Kirk’s termination (Stuevecke v. New York Hosp. Medical Center of Queens, 2003 WL 22019073, E.D.N.Y.,2003; Bekker v. Humana Health Plan, Inc., 229 F.3d 662, C.A.7.Ill., 2000). The procedure for termination of employment and cancellation of privileges must also be determined based on the terms of the employment contract and based on applicable laws, rules and regulations. If the procedure is followed then, I would approve the proposed action. If the procedure is not followed then I would disapprove the same. In the given scenario, it seems that there was no sufficient notice made to Dr. Kirk which may be in violation of the due process clause enshrined in the Constitution. Unless there is enough basis for his immediate termination and cancellation of privileges, I would withhold my approval. The issue of good faith and fair dealing must also be examined if it is contained in the said employment contract. If there is such a requirement then, there would have to be a determination of good faith and fair dealing based on the records and circumstances presented. In the given scenario, there seems to be bad faith as the real basis for Dr. Clark’s termination is really the bonuses that will likely suffer instead of the work efficiency which should be the basis for any continuation or termination of employment. Hence, I would have to withhold my approval. On the other hand, if there is no such requirement, then I would approve the proposed action. Finally, on the issue of the cancellation of privileges and credentials, my position is that it should not be cancelled without due process. As stated in the case of Christhilf v. Annapolis Emergency Hospital Association, “Medical staff privileges, once granted to a physician by a hospital, have been held to constitute such a valuable property right that they cannot be taken away by the hospital without affording the physician the constitutional safeguards of the due process clause of the fourteenth amendment,” (Christhilf v. Annapolis Emergency Hospital Asso. (1974, CA4 Md) 496 F2d 174). References Bekker v. Humana Health Plan, Inc., 229 F.3d 662, C.A.7.Ill., 2000. Christhilf v. Annapolis Emergency Hospital Asso. (1974, CA4 Md) 496 F2d 174). Shepard, M. (2007). Cause of Action Against Employer for Breach of Covenant of Good Faith and Fair Dealing in Employment Contract. Causes of Action First Series, Volume 26 (175). Stuevecke v. New York Hosp. Medical Center of Queens, 2003 WL 22019073, E.D.N.Y., 2003. Read More