Medical Staff Plans: Rightsizing in a Healthcare Reform Environment

The impact of the Affordable Care Act on clinical practice patterns has influenced the utilization of and need for most physician specialties. Completing a medical staff development plan will help a health system or hospital right size its medical staff in light of these impacts, and ultimately help determine community need for physicians.

Yet too often, health care organizations don’t consider the full intricacy required to generate a robust medical staff development plan. A fully developed medical staff plan must:

• Account for changing care patterns
• Be certain that any physician-to-population ratios applied are actually relevant in a specific market
• Apply regionally specific practice patterns to the maximum extent possible, rather than making assumptions based on national data
• Take into account the time that physicians spend on non-patient care activities
• Consider the impact of advanced practice clinicians (nurse practitioners, physician assistants, and others)
• Adjust for the fact that many medical subspecialists devote a portion of their practice to primary care
• Account for the role played by hospitalists
• Be based on an appropriate role for physicians in the planning process

Medical staff development plans, when done well, address physician need at multiple levels to benefit the community at large, the hospital or health system medical staff, and individual physician practices. But hospitals and systems must proceed with diligence and care to avoid pitfalls that can derail accuracy and successful outcomes.