Kitch - Attorneys & Counselors
Medical Staff Bylaws


There are several reasons why we excel in the development of medical staff bylaws, rules and policies:

First, we understand the needs of medical staffs and bring to the table a very extensive knowledge of problems at other institutions and how to develop bylaws to avoid those problems in a manner that accommodates both medical staff and board concerns. 

Second, we have a solid understanding of litigation.  Medical staff bylaws should be drafted in a way to minimize the risk of adverse litigation from malpractice plaintiffs or disappointed applicants who try to use the bylaws as a "sword" to build a lawsuit against the medical staff members or the hospital. 

In addition, we are very innovative and practical in addressing legal and accreditation requirements, often in ways that protect the interests of individual physicians, yet accomplish medical staff and hospital compliance objectives.

Development of quality medical staff bylaws requires a "vision."  Those responsible for either developing or revising bylaws must first identify what their objectives are for bylaws design (comprehensive bylaws vs. skeletal constitution style bylaws with comprehensive rules and policies), medical staff structure (departmentalized vs. centralized credentialing and peer review), credentialing procedures (e.g., pre-applications vs. preliminary non-substantive review and fast tracking), credentialing requirements (will board certification be a benchmark or a minimum requirement), how will disciplinary and hearing processes be structured (one size fits all vs. progressive and layered) and philosophical and technical style decisions (who will be members of the medical staff apart from physicians?).  We help our clients find this vision of what they truly want and need and keep this vision in the forefront throughout the bylaws development process.

After the "vision" comes the obligation to create bylaws that meet the demands of today's regulatory and legal environment. Our goal is for our clients to have bylaws that meet the following criteria:

  1. Compliance with Joint Commission or AOA requirements
  2. Compliance with the state licensing act
  3. Compliance with the Medicare Conditions of Participation
  4. Compliance with the Health Care Quality Improvement Act of 1986, to the extent that the Hospital and its medical staff wish to maximize the availability of its limited immunity provisions
  5. Minimizing malpractice liability exposure to medical staff members and the hospital
  6. Minimizing exposure to medical staff litigation, including but not limited to, denial of "due process," discrimination (like ADA) and antitrust claims.

We believe that bylaws, rules and policies must be understandable and readily usable if they are to be used effectively.  Specificity is especially important, not only to comply with accreditation requirements, but to know "what to do next" when something out of the ordinary arises.  Understandability also minimizes uncertainty that could lead to or support litigation.  Moreover, medical staff documents should be able to be used without the necessity and expense of legal assistance for every issue that arises. 

Gregory Drutchas
T (313) 965-7930