Practitioner Impairment in Healthcare

Study Notes

Practitioner Impairment

Healthcare professionals are accountable to the public for maintaining high professional standards.
The governing body of a healthcare organization is ultimately responsible for quality care.
An impaired practitioner is unable to perform duties safely due to physical or mental illness, age deterioration, or substance abuse.
Organizations require policies for identifying and managing impaired practitioners, including investigations, treatment recommendations, and potential separation.
Hospitals have processes for reviewing provider credentials and performance, as well as overseeing employment actions.
National and state licensing authorities enforce legal requirements for reporting impaired practitioners.

Changing Nature of Healthcare Professions

Healthcare delivery has shifted from hospitals to outpatient facilities, homes, long-term care, and community settings.
Major forces driving this shift include:
- Increased reimbursement for outpatient settings and focus on cost containment.
- Technological advances like telehealth and electronic health records.
- Medical innovations allowing complex procedures to be performed with less hospital stay.

Physician and Healthcare Organization Relationships

Physicians can practice as individual providers or in groups, referring patients to hospitals.
Individual practice doctors usually hold admitting privileges but are not governed by the hospital.
Physicians “on staff” at hospitals are credentialed by credentialing committees and governed by medical staff bylaws.
Over half of US physicians are employed by hospitals or hospital-based systems, creating different governance and HR policy accountability.
Employed physicians may maintain private practice in addition to hospital employment.
The field of hospital medicine, or hospitalists, has rapidly expanded, focusing on specialized inpatient care and not running independent practices.

Trends in Physician Practices

Most hospitals employ Chief Medical Officers (CMOs) to oversee hospitalist responsibilities.
The majority of physicians now work outside private practice due to changing reimbursement models.
Only 5.8% of physicians work as independent contractors.
More than 25% of physician practices in the US are owned by hospitals or hospital-based systems; an additional 27.2% are owned by corporate entities like insurance companies and private equity firms.

Description

This quiz explores the implications of practitioner impairment within healthcare organizations. It focuses on the responsibilities of healthcare professionals and governing bodies in maintaining quality care. Understand the challenges posed by impaired practitioners and the standards they are held accountable to.