QUESTION:        We have several physicians who are chronic outliers in medical record completion. They are all good clinicians and a few are in specialties that we really need here, but it’s getting to the point where it’s affecting continuity of care and, quite honestly, the hospital’s bottom line. What is the best way to deal with this?

ANSWER:            It’s pretty much a guarantee that on every medical staff there will be a handful of outliers in this area, meaning physicians who are chronically late or incomplete with medical recordkeeping. Traditionally, the medical staff response to those situations has been to “automatically suspend” the physicians, although we believe the term “automatic relinquishment” is a more appropriate way to describe the situation.  Calling the physician in to meet with the MEC sometimes works because it is hard to look colleagues who are every bit as busy as you are in the eye and explain why one physician can’t do what everyone else is expected to do.

Some organizations have tried not insignificant monetary fines which must be fully paid for the physician to remain eligible for appointment to the medical staff. A few organizations have even tried the imposition of additional emergency call for those physicians who are chronic outliers. It is clear that medical recordkeeping requirements must be enforced, for many regulatory, legal, accreditation and patient care reasons. In the current era of physician employment, the employer likely has additional “enforcement mechanisms” available under the contract.