Does A Physician Office Need To Provide A Wheelchair

I am having hard time with this question please. Heres the scenario and if you know the answer or cant even discuss, DONT LEAVE ME ANY FUNNY ANSWERS PLEASE!



FACTS: You are the administrator of St. Ives Hospital and Clinics, a 150-bed inpatient and outpatient facility wholly owned and operated by St. Ives Healthcare, a not for profit healthcare system operated by the State. You report to the Chief Executive Officer of the hospital. Your medical staff includes both employed physicians of the system, all of whom are employed by means of employment contracts, and private physicians who have privileges to admit patients to the hospitals. Your employed physicians are not unionized.



In some specialties, private physicians and some group practices have non-exclusive contracts to provide services in the facility, and also provide services at other facilities in your area as well as in privately owned ambulatory surgical centers.





One day, your chief of medical staff, Dr. Clark, approached you after a meeting and asked for your assistance. "You know Dr. Kirk, in cardiology, don't you?", he asked. You replied that you did. Dr. Kirk is a well-liked older physician who has been with your institution for at least 35 years. He had recently been ill with a chronic joint ailment, and and after several surgeries returned to work needing assistance in the form of a wheelchair. It appears that his need will likely be permanent. "Well," Clark continued, "This is the second consecutive quarter that he hasn't met our department productivity goals, even taking into account his sick leave." You noted that Clark is also a cardiologist with staff privileges.



You are also aware that about six months previously, the Ives HealthCare System Executive Management had promulgated an "Incentive Productivity System" with certain goals for providers to meet, in an effort to begin to tie compensation to financial productivity throughout the system.



Dr. Clark continued: " All our bonuses are going to suffer unless he and others like him are removed from the database".



You inquired what, exactly, he meant by 'removed from the database'.



Clark replied, "you know , the financial wizards at administration only crunch numbers. We really don't have a choice here unless we all want to suffer. I'm canceling his privileges and credentials here, and I am giving him his termination today. I think it's within my authority to do it. But I think I should have a letter from you approving it."



You returned to your office to ponder what had been asked of you and the situation presented. Later, as you were pondering the issue, Clark came to your office.



“Oh, yes, I think you ought to see these too,” Clark stated.

He presented you a list with three names and identifying case numbers on it, on a handwritten note.



“It has been discussed by the OR Nurses and the residents that they have some concerns about Kirk. They think he messed up in a couple of cases. I’ll have the files brought to you, but that should make your decision easier….”.



Please respond to the scenario as stated above.

For this scenario, I would first review the case files to determine exactly how Kirk messed up on each case (if he even messed up at all). Then, I would take his productivity into account. If he is no longer an asset, you can terminate him. Also, his contract is non-exclusive, and he is working for other facilities besides yours. You may also want to contact those other facilities before terminating him, in order to see how his productivity is, as well as how he handles his cases. Then you may come to a decision. Firing him because of lower bonuses is not the way to go, and he may sue for discrimination (since he is now in a wheelchair). Best to have your facts ready. :)

Hoped this helps!!!

2009-02-10 11:46:40 by Bugsy B