The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three types of advanced practice registered nurses (APRN): certified nurse-midwives, nurse practitioners and clinical nurse specialists. Certified registered nurse anesthetists were not given full practice authority under the final rule, which goes into effect January 13, 2017.

A primary goal of my work in consulting and writing, including this book, is to help medical staffs move from a punitive or indifferent peer review culture to one that supports physician improvement and the pursuit of excellence. The good news is that peer review culture can indeed change. However, although policies can change quickly, true culture change is slow, often taking several years depending on the size of the organization. But how do you get there? In my experience of working with medical staffs, I have seen three keys to successful cultural change related to peer review.

There are many reasons why physicians and medical staff members take leave of absences. Whatever the reason, it’s important to have a policy in place to address reappointment following a leave of absence. Today’s free resource is an outline on how to create a leave of absence policy. It was created by the medical staff office at American University Beirut Medical Center, a Joint Commission International-accredited hospital in Beirut, Lebanon, for its credentials committee. The presentation explains what a physician leave of absence is and how to credential and privilege a physician coming back from one.

Todd Sagin, MD, JD, brings a unique perspective to the medical staff field with a background as a physician, medical staff leader, and a lawyer. Sagin is now the national medical director of Sagin Healthcare Consulting, LLC and HC Healthcare Consultants, LLC, and frequently is exposed to the daily struggles faced by today's medical staffs.

An ACGME task force recently issued recommendations regarding changes to its Common Program Requirements regarding duty hours. A public comment period is now underway. A key part of the recommendations propose greater flexibility in resident work hours as generally tested in the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial, including allowing first-year residents to increase their shifts from 16 hours to 24 hours, which is allowed for all other residents.

"Absence of data does not mean that there is no risk."

--Senate Finance Committee Report addressing the practice of concurrent surgery.

Consider whether a performance deficiency should be handled as a medical staff issue or an employment issue. The employed physician might argue that clinical and behavioral issues should be handled through the medical staff bylaws, which guarantee extensive due process. Handling a physician performance concern as an employment issue may deprive the physician of the checks and balances available through the medical staff bylaws.

Although CMS has now substantially limited the ability of a hospital to establish provider-based (PB) locations, they have been extremely popular over the past few years because they allow a hospital to bill for services as if they were provided at the main hospital building (i.e., each service generates both a facility fee and a professional fee). 

A new California law lifts a century-old ban on direct physician employment and aims to end a “doctor desert” among the smallest and most remote hospitals.

Brand-new to CRC? Looking for a sneak peek into what an upgraded membership would bring? Need a refresher on how to access the arsenal of expert analysis, training resources, and networking opportunities already at your disposal? Whatever your goals, the CRC team has you covered. Click here for tools, how-tos, and quick tips for putting your membership to optimal use.

CRC wants to know: What will 2017 hold for MSPs and medical staff leaders? Send your professional aspirations, inspirations, predictions, plans, and advice for the year ahead to Editor Delaney Rebernik at drebernik@hcpro.com, and you could see your contributions featured on CRC’s site and social channels.

The CRC homepage is sporting a brand-new polling feature. Our first question asks site visitors for their take on which verbiage best represents those in the MSP profession: “medical staff professional” or “medical services professional.” 

Click here to access the poll directly. You must be signed in with your free or paid CRC account to participate.

Have a hot medical staff or credentialing topic you’d like your peers to weigh in on? Send question and topic proposals to CRC Editor Delaney Rebernik at drebernik@hcpro.com, and you could see your idea showcased in a future poll.   

Your window into the professional experiences of MSPs across the compensation spectrum, career stages, and the care continuum.

Looking for a way to honor a colleague or yourself for a successful year? Looking for a way to attend an educational conference for free? CRC's Achievement Awards honor MSPs and medical staff leaders who make a difference in their organization and serve as an inspiration to the broader professional community. Winners of these three achievement awards will be recognized at the 2017 CRC Symposium and will have free entrance into the 2-day learning event. For more information, click here.