In setting up this website I have started to think about how much of our medical staff activity should be private and confidential. Obviously, individual patient issues are private. So are medical staff disciplinary and complication proceedings.

On the other hand, our hospital's performance on the JCAHO audit is public information. Hospital finances are entirely public. Physician discipline once adjudicated is public.

Here's what I propose:

(1) Minutes of meetings where policies are determined should be publically available through this site. We should be able to, for example, defend our clinical pathways to all and sundry.

(2) To the extent possible, aggregate information on the mechanics of quality should be publically available. We all understand that medicine is a harsh mistress, but if the flowers aren't being delivered on time she gets particularly cranky.

(3) Policy issues should be discussed loud and long and in public. For example: a trial balloon was lofted by administration that we should look to "streamline" the medical staff by reducing the number of active medical staff. I am agin it. I'd like to know if my colleagues care.

(4) Finally, there is the issue of money. I, for one, do not particularly see hospital budget matters as our concern, unless we are lacking for equipment or materials. As a 501c(3) Marin Community Health's budget should be public. If anyone wants to find it and commit to keeping the data current, I would be happy to stick it up on the site.

-- Harry Neuwirth (hneuwirth@aya.yale.edu), April 04, 1999

Answers

How about putting the Hospital Lease from the public board online. I know its long however it can be useful as a reference. Keith

-- Keith Denkler (kdenkler@well.com), April 10, 1999.

I will try to find a wordprocessor version of the lease and put it up here.

-- Harry Neuwirth (hneuwirth@aya.yale.edu), April 10, 1999.

I put up the lease and its 1987 amendment. they are accessible from the home page

-- Harry Neuwirth (hneuwirth@aya.yale.edu), April 13, 1999.

I am confused about the idea of streamlining the medical staff? What is the exact proposal? Certainly there are many members of the staff who do not concern themselves with policy issues.

-- lizellen la follette (pmhorn@mindspring.com), April 14, 1999.

I think that by "streamline", hospital administrations mean to reduce the number of active staff. Active staff vote and the administration's perspective may be that physicians who do not use the hospital much should not share in the vote. Personally, I think that attitute is misguided. I think we need the broadest possible medical community.

-- Harry Neuwirth (hneuwirth@aya.yale.edu), April 14, 1999.