Executive Session Freakout

Why are administrators freaking out over medical staffs meeting in executive session?

Executive session is a common parliamentary procedure in which non-members of the committee or department or medical staff are asked to leave the meeting so that members can discuss and vote on an issue in private. Executive session allows frank discussion, which might be chilled by the presence of administrators. Calling an executive session can allow business to progress by avoiding tabling an issue to allow members can discuss it among themselves. It’s a great tool for well-informed, expedited decision-making.

So why do some hospital administrators refuse to agree to executive session provisions in medical staff bylaws? The argument that to be collaborative, the hospital administrative “team” must be present at every minute of all medical staff, department and committee meetings does not ring true when countless administrative meetings convene without a medical staff representative in sight. Medical staff members don’t need to be at every nursing or management meeting, why must medical staff meetings always include administrative personnel? Refusal to allow the medical executive committee or other medical staff committees to meet with out being supervised/watched/monitored by administration seems a sign that a hospital is in serious trouble—or at least gives rise to suspicions that the hospital is in trouble and is up to something. Clearly, it establishes that the hospital administration does not trust the medical staff.

Note that “The AMA (1) supports the right of any hospital medical staff committee to meet in executive session, with only voting members of the medical staff present, in order to permit open and free discussion of issues such as peer review and to maintain confidentiality; and (2) encourages individual medical staffs to incorporate provisions in their bylaws to affirm this right.” AMA Policy Compendium H-235.987. AMA is not famous for harboring radicals or generating maverick policies. Doctors may need to discuss clinical issues-or problems with hospital personnel-among themselves to get to the root of a problem without being under an administrative microscope.

To avoid this sort of medical staff surveillance:

* add executive session language to the bylaws, such as:

At the call of its chairman, any medical staff committee or department may meet in executive session, with attendance restricted to medical staff members and any advisors or other assistant as the chairman may specifically request to attend.

* if administrators refuse to leave the room, table the agenda item until the next meeting, and hold an interim members-only conference call to discuss and determine the outcome to be formally taken at the next meeting. If administration does not want to slow business down, it will start honoring executive session.

© 2009 Elizabeth A. Snelson, Esq.
Questions? Comments? easesq@snelsonlaw.com
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