Physician Membership On Hospital Boards Benefits, Problems, And Solutions

PHYSICIAN MEMBERSHIP ON HOSPITAL BOARDS BENEFITS, PROBLEMS, AND SOLUTIONS

A hospital's organizational structure is extremely complex. It is very important that hospitals develop strategies that will ease unnecessary pressures and allow for more focus on innovation and quality of care for its patients. An effective way to do this is to reorganize the hospital board and integrate participation of physicians. The board must have the right information to make effective decisions and the ability to work together as a team. With the right strategy, the hospital's goals can be met.

Benefits of Physicians on Hospital Boards

Physicians in governance bring many benefits to the hospital. The first of these benefits is adding physicians bring a clinical perspective to the board. Physician involvement can improve the quality of strategic planning and capital expansion activities. Physician board members also carry a fiduciary responsibility and gain a greater appreciation for the administrative perspective on financial decisions (Goes, 92).

Studies have shown that physician involvement in hospital governance will be positively related to hospital profitability and efficiency, and negatively related to uncompensated care and hospital costs. Hospitals with greater physician membership on their boards were more profitable, had higher occupancy rates, delivered less care that went uncompensated, and incurred lower average costs in ancillary services (Goes, 94).

Physicians on the hospital board give solutions to the hospital's relationship with the community. Physician participation gives back the three T's of governance--time, treasure, and talent (Totten, 49). The philanthropic support that lacks in many communities is revitalized with physician involvement on the board. Physician contribution to the board can help guide the hospital by establishing and maintaining the public's trust, being good stewards of the community's resources, and ensuring high quality care (McDonagh, 31).

Physicians serving on the hospital board can act as a liaison between the board and the medical staff. They can reassure the medical staff that the board and administration know their concerns and what they are doing. If this reassurance isn't effective, the physician can signal the CEO that more in-depth communication with the medical staff needs to be addressed (Maidlow, 28). Physicians also help the board to better understand patient needs and what is best to ensure continuous quality of care for patients.

Problems with Physicians on Hospital Boards

The benefits of physicians serving on the board of trustees are numerous. There are, however, many problems that could arise. The first of these is that a physician board member possesses an insider's viewpoint in the hospital. This can result in conflicts of interest. Conflicts of interest can exist when physician board members have significant financial interest, are involved in outside activities, or have a relationship with customers or competitors of the hospital. These problems occur when physicians are looking out for his or her best interest instead of focusing on what is best for the hospital.

The physician will often vie for medical staff interests instead of looking to the best interests of the hospital as a whole. Since physicians learn very few management skills in medical school, they can often lose the management aspects of the hospital. The costs and management concerns are often put on the back burner, while what the medical staff wants takes precedence.

Independence of physicians is very important. They do, however, often become too independent of the board. Physicians sometimes do not keep an open mind to all aspects of the hospital. They should always focus on taking care of the needs of the medical staff as well as the hospital as a whole.

Solutions to Physician-Board Problems

One solution problems that physicians serving on hospital boards can cause, is looking to outside board members. They are not constrained by community pressures and reprisal for making difficult and sometimes unpopular decisions (Totten, 51). These people are more able to retain their independence and avoid conflicts of interest. Another advantage of seeking board members from outside of the community is increased access to skills that may not be available locally. This can be especially beneficial to small and rural communities. Hospital boards that want to consider seeking board members outside of the community can begin by adding one or two members and examining the results that occur (Totten, 51).

A physician's perspective on the board can be from a physician who is not a member of the hospital's medical staff and who live and work outside of the communities served by the hospital (Totten, 46). These people can stimulate new ideas and concerns that might have been overlooked otherwise. Physicians who are retired and have independent points-of-view from the medical staff can also be candidates for the job.

CEOs should be aware of the problems that physician board members could face. Physicians usually do not possess the skills and perspectives that other board members who are business professionals have. Physicians should be aided in understanding

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