One of the things I am most proud of during my career was being elected by my colleagues to be the chairman of the Obstetrics and Gynecology Department not once but three times. The responsibility of overseeing the medical department of a hospital was something that I was privileged to do and enjoyed very much. The position meant many extra hours at the hospital at meetings with nurses, other doctors and hospital administrators. Again, I must thank my family for giving me the support during the many extra hours I was away from them. As chief I also served on the hospital’s Executive Committee, which enabled me to have some input into many of the policies and long-term goals of the hospital and its staff. I represented 15 to 20 physician members of the department at those meetings so that we could have a say in its governance. Most of the duties, while very time-consuming, were quite rewarding except when it involved disciplining other physicians. While that was unfortunately necessary a few times, it disturbed me quite a bit. But the public needs to know that we do police ourselves, as hard as that may be to do. It is difficult to put friendships aside and do what is right if someone has stepped out of line. The duties gave me added insight and a better understanding of how a large institution is run and administered. I must say that I went into the position with certain biases against hospital administrators but came out with a much clearer understanding and respect for those people. But most of all, I enjoyed representing the members of the department whom I respected greatly. I took it very seriously to make sure that I lived up to the confidence they had in my ability to bring their thoughts and concerns before the administration. I learned that most decisions are compromises and that you cannot always win all the battles. It made me a truly more knowledgeable physician and I value what I learned from the others I was involved with very much.
The hardest part of being department chairman was disciplining other physicians. As doctors we are and should be held to a higher standard of behavior. When a physician violates the code of conduct of the hospital its leaders must step in and uphold the rules and regulations we are bound to live by. These violations could involve simply not attending the required number of meetings of the department, failing to complete medical records in a timely fashion or it could involve more serious offences like abusing members of the hospital staff. All of these situations require a meeting between the chief of the department and the physician involved. Although I did not enjoy these meetings it was necessary for the efficient running of the hospital and department that they occur. Most of the time, I found that the physicians involved were embarrassed that they had violated the rules and were very apologetic. They understood that it was nothing personal on my part but the rules are the rules and no matter who violates them there are consequences. To the credit of most of these doctors they rarely turned out to be repeat offenders. However, there were a few who continually seemed to get into trouble.
The most common violations involved medical records. It is very important for many reasons that medical records be completed in a timely fashion. This could involve signing verbal orders given to a nurse over the phone, signing dictated patient histories or completing operative reports. The hospital is subject to regular inspections by state authorities like the Joint Commission on Accreditation and these things are looked at closely by these inspectors. If it is deemed that too many charts are incomplete the hospital could be placed on probation or lose its accreditation all together. So as trivial as these things may seem to some they can have serious consequences. I must say that completing charts is not a favorite job of mine either but it must be done. The need to discipline a physician for these offences was something I found difficult but as you can imagine necessary. I did not enjoy doing it, but I tried to be as fair as possible and yet still do the job I needed to do.
Occasionally a physician would be guilty of more serious violations of the code of conduct. I think after having read the book to this point you should understand that some physicians have ego problems. Some of them let their emotions get out of control and wind up in various situations where they were guilty of abusing nurses verbally. This was something I personally could not understand or tolerate. These were deemed serious violations by the hospital administrators also and they were dealt with severely. While these occurrences were few and far between they could not be tolerated. While most of these incidents involved verbal abuse, occasionally it involved sexual harassment. Physicians are human beings and like other members of society we are sometimes guilty of the same kinds of misbehavior. I found these situations to be the most difficult to deal with because I could not understand why these things occur at all in our society let alone within the medical profession. However, to the credit of the profession they were the rare exceptions. Most physicians have the highest regards for the nurses they work with. We depend on them to carry out the care we wish our patients to receive and without them, the true “angels of mercy,” our care for others could never be accomplished. They work long hours without complaints to provide the care the public needs and I for one respect each and every one of them for the kindness and support they give to those in need. I hope all patients when they leave the hospital after an illness make sure you say to your nurse - “thank you!” I can tell you how important that is because I’ve heard from so many nurses who have told me they were so happy that my patient came to them and said thank you.
As a member of the executive committee I sat in on many of the planning decisions of the hospital. That included a large merger with several other hospitals in the area. I learned an awful lot about the inner workings of the hospital that, as a private physician, I had no idea about. It was also my job to bring any significant problems that the department was having before the committee for help and guidance in resolution. The committee included the Chiefs of all the other departments, the medical chief of staff and several administrators. They were all very talented, well-respected and educated people and I enjoyed interacting with them. If there was a problem in the hospital, we knew about it and were involved in its solution. The meetings usually were monthly but, occasionally, more frequent. Many times they went on late into the night or early morning until all the business was concluded. I enjoyed being in the middle of everything that was happening in the hospital and, as I said, learned a great deal from the wise and talented people that I worked with. Running a hospital is a tremendous responsibility and I was pleased to be involved in helping to make our institution one of the best in the area. Whatever hard work was involved was rewarded in many more ways of knowing how important the work was and the process of finding solutions for its complex problems.
Finally I would like to thank all the members of the department for the confidence and privilege that they extended to me by electing me their chairman. There is no higher honor than to be recognized by your peers to represent them on these important matters.
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