Healthcare Law Options in By-Law

Healthcare Law

Options in by-Law Alteration

There is some evidence that pay and job security based on performance is an effective way both to improve the effectiveness of care and to produce cost-savings for the hospital organization (Petersen et al. 2006). The decision to remove doctors and other members of the medical staff without any consideration for the input of the medical staff will likely lead, however, to a great deal of political resistance from the medical staff and is therefore not advisable. This would be a legal measure, however the effects of such a policy on medial efficacy are unknown (Petersen et al. 2006).

The option of changing bylaws to redefine the standards of necessary care and to explicitly include economic performance as a factor in care strategies is highly advised. Not only would such a change be acceptable to the majority of medical staff members, but it would also likely lead to better economic performance and more efficient physicians (Petersen et al. 2006).

The option of finding medical and political reasons for firing physicians that underperform economically is highly unethical, potentially illegal, and is certainly bound to raise the ire of medical staff. While economic factors can be linked to medical factors and to job security the subterfuge and dictatorial perspective this route employs would not be tolerated (Petersen et al. 2006).

The more complex plan of eliminating one third of all physicians, limiting practice opportunities, and reducing contracts to a period of one year would be legal, however is unadvisable for the reasons stated above.

Network Responses to Contract Sticking Points

The negotiating point here is fairly easily compromised given physician willingness in the creation of a network price for services as determined by averages of the standard charges of network physicians for these services. This allows for the maintenance of a Network price list, as stipulated in the Physician's version of this clause while still tying price (as well as incorporating the discounts) to standard physician charges, as stipulated by the Network. The Physician's current version of the compensation clause is untenable, however, as it limits the freedom of market forces to have their effect on price, which is unfair to the network and will most likely create higher costs to the network and its clients thus eliminating benefits to clients.

Again, the terms of the Physician's version are unacceptable to the Network as it will eliminate any benefit to clients. The affiliation of hospitals with the Network is a possible point of negotiation as long as other hospital services are not charged to the Network.