AMA meeting: Principles aimed at better physician-hospital relations

The new policy could help doctors resist what they perceive as hospital leaders' attempts to undermine physician autonomy and interfere with patient care.

By Kevin B. O'Reilly, AMNews staff. Dec. 3, 2007.

Honolulu -- The American Medical Association House of Delegates adopted 12 detailed principles aimed at easing strained physician-hospital relationships, protecting medical staff self-governance and improving health care quality and patient safety.

Until last month's Interim Meeting, the AMA had no house policy outlining the organization's stand on physician-hospital relations.

Physicians believe the new principles guiding how they work with hospital leaders should "expedite discussions with the AHA, the Joint Commission and the Centers for Medicare & Medicaid Services and ultimately signal to the health care community that there is an urgent need to find and build upon common ground between physicians and hospitals," the adopted resolution says.

"This is a vital struggle," said Brian D. Johnston, MD, a California emergency physician and delegate from the Organized Medical Staff Section. "If physicians lose self-governance, our patients will be harmed, our hospitals won't function as well and we won't be able to practice medicine to the best of our ability."

The new policy comes on the heels of a pitched battle between organized medical staffs and hospitals over revisions to Joint Commission Standard MS.1.20, approved in June. The standard centers on what components of governance must be included in organized medical staff bylaws -- and therefore voted on and approved by physicians -- and what can be addressed in the administrative rules, regulations and policies that hospital boards and medical executive committees decide.