Single, separate medical staff
AHA president and CEO Rich Umbdenstock's letter accused CMS officials of pulling "a surprising and impermissible about-face" in requiring that each hospital, regardless of whether it is a part of a multi-hospital system, have a single and separate medical staff. He likened it to "a surprise switcheroo."
Umbdenstock says that such language was not in the proposed rule, and in fact, the proposed rule mentioned "that some systems had unified their governing boards. The only possible interpretation of this section ...is that CMS concluded that its language permits a unified medical staff, and it was not proposing to change that."
If in its proposed rule CMS had indicated it was considering such a change, "the affected stakeholders would have described the enhanced ability of their medical staffs, working as a unified body, to more effectively and efficiently review, credential and privilege individuals seeking staff privileges."
Having one medical staff serving a whole health system would be more effective in standardizing high quality and safe care, address knowledge gaps, "before patient care suffers." In fact, many health systems have already unified their medical staffs by adopting medical staff by-laws, policies and procedures.
But James Madara, MD, AMA executive vice president, says his organization "strongly supports" the rule.