Changes in medical staff bylaws could protect radiology contracts

Support from hospital medical staff and bylaws that give the staff a stronger role in scrutinizing staffing decisions could help protect radiology practices against hospital management dropping their contracts, the administrator of one of the largest practices in the country contends.

The practice, Radiology Associates of Sacramento, just lost a major contract with Sutter Health, even though the practice enjoyed strong support from the Sutter medical staff.

Sutter Health severed its contract with Radiological Associates of Sacramento on April 1. RAS has 78 physicians, 60 of them in diagnostic radiology and nuclear medicine. Instead of contracting with another radiology group, Sutter hired radiologists to work for its own multispecialty group, Sutter Medical Group.

The decision to terminate the contract was not popular among Sutter Roseville Medical Center’s doctors. The medical staff at the facility voted unanimously March 9 to keep an exclusive contract with RAS and so did the medical executive committee. The hospital administrators and board of directors went against the medical staff’s and the executive committee’s wishes and ended the contract anyway.

“It’s a shame,” said RAS executive vice president Fred Gaschen. “Basically, the hospital’s actions said, ‘We really don’t care what you think.’”

What happened with RAS doesn’t have to happen elsewhere. Gaschen’s advice is to put more teeth in the medical staff bylaws. He suggests modifying them to say if there is a change in any hospital-based physician staffing, the medical staff opinion cannot be overlooked.

“It’s really inappropriate, from a patient safety and patient care perspective, to have medical staff completely behind you, and then have administration and the board of directors ignore [that] based on business reasons,” he said.

Gaschen also wonders how much risk hospital administrators take when they go against the medical staff opinion.

“I’m not an attorney, but it just seems to me I would err on the side of caution,” Gaschen said. “If my medical staff said, ‘this is what we want to do for patient safety and quality of patient care,’ I’d follow that.”

If hospital bylaws are changed to increase the medical staff’s say when it comes to contracting with radiologists, maintaining a good relationship will be more important than ever.

“I think any radiology group that doesn’t have a good relationship with its medical staff really isn’t doing itself a favor,” Gaschen said.