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Hi, everybody.

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Welcome to module eight.

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This module's focus is a broad
category of medical staff,

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how we choose them, what
our responsibilities are,

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how it fits into this
overall hospital structure.

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Traditionally, medical
staff have been just one leg

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of this three legged stool
of the hospital structure.

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Two other legs being governing
body and the management team.

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All three legs of the stool
have this role to play

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in the medical staffs
organization and how it functions.

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As we talked about, hospitals
are big complex organizations.

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We often just think of medical services

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like clinical operations
as what a hospital does.

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Most Americans do.

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However, the complex systems
of modern hospitals include

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teams for medical equipment,

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for technology, laboratory,
diagnostic services,

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not to mention all the
other patient care services

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connecting with other external partners.

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Hospitals have enormous structures.

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As many of you know, hospital
administrators are responsible

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for the overall management
and operation of a hospital

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or healthcare organization.

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The primary role of
these folks is to ensure

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the hospital runs smoothly,
efficiently, effectively,

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help promote high quality care.

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Other roles that have
leadership components

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that are important parts of hospitals

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or healthcare organizations,
human resources,

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responsible for recruiting, hiring,

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training, managing professionals

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and staff, which includes
physicians, nurses,

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other healthcare professionals,
support staff, technicians.

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Likewise, facility management huge part

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of a hospital structure.

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They're often responsible

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for maintaining the physical
infrastructure, buildings,

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equipment, grounds.

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Hospital campuses are now
pretty big, as you know.

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Informational technology.

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So those who oversee
electronic medical records,

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patient portals, those
digital healthcare records,

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digital healthcare tools.

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Many hospitals have
quality improvement teams

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or agencies or even departments

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to ensure the hospital
provides high quality care,

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meets or and exceeds
standards, meets regulations.

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And that can include legal teams.

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And finally, hospitals have integrated

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or collaborative community
programs, those who work with

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healthcare providers outside the campus,

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government agencies to help promote access

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to healthcare services.

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So as we all know, healthcare
is not just about doctors,

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nurses, and patients.

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There's all these different roles,

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including those folks
coming to the hospital

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to do their work.

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One of the interesting
questions that we're now ready

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to start talking about is, does
that make them an employee?

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This complexity in how the law works here.

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Let's start with hospital
privileges, for example.

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Hospital privileges refer
to that permission granted

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by the hospital or the healthcare
facility to a physician

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or maybe another healthcare provider

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to perform specific medical procedures

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or treatments in that facility.

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It does not make you an
employee of the facility,

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but you come into the
facility to do your work.

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Hospital privileges are granted
based on qualifications,

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training, experience,
professional credentials.

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Healthcare providers must be granted

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hospital privileges before they provide,

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they do their job in that setting.

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Process of obtaining
privileges usually is complex.

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It involves submitting an application,

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reviewing your qualifications.

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You know, there might be
a team that reviews it,

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including, you know, what is
the professional's education,

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training, clinical experience.

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This might be done by a committee.

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There might be an interview process.

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They determine your clinical
skills, your expertise.

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So once granted,

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a physician or another
healthcare practitioner

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might be granted hospital privileges.

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And so then you can perform
your specific procedures

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or treatments in the
facility, in the hospital,

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somewhere on that campus.

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These privileges are typically granted

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for a specific period of time.

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They can be remote, revoked if
the provider fails to comply

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with policy procedures
or maybe even standards.

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And a good example of this
might be surgery, anesthesia,

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obstetrics, gynecology, cardiology.

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So maybe a smaller hospital
doesn't have these specific

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practices or physicians working there.

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So they give them privileges
to come in and do that work.

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Hospital privileges
are an important aspect

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of our whole healthcare delivery system

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to help ensure patients receive good care

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from qualified and experienced
healthcare providers

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and receive care in a
wide array of services.

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So as I talk about that

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you might be thinking about
last week and the week before

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discussion about like, oh,
independent contractor.

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Exactly.

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So an independent contractor in healthcare

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is a professional who provides
services on, you know,

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a contractual basis rather
than being employed.

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There's a different employee
employer type of relationship.

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Independent contractors can
include physicians, nurses,

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therapists, other healthcare providers.

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You can even have janitorial

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or environmental services
be outside contracted.

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'Cause the independent contractors,

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healthcare professionals,
they're not employees

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of the healthcare facility

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and they're responsible for
you know, their own things,

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taxes, insurance, business expenses.

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They might work for an
entity that provides

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all these outside contracted services.

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They might work for themselves.

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They can work on a
freelance or per diem basis.

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They might work for multiple
healthcare facilities

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or organizations.

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Maybe they, you know,

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do different hospitals on
different days of the week.

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So independent contractors
in healthcare are often

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providing these specialized services

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at a healthcare facility
to fill in gaps in staffing

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or to provide some kind of expertise.

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A hospital can contract with
an independent physician

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to cover a specific medical specialty,

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because they don't have that

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they might contract with a you know,

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a therapist to do services
that they don't need full time.

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The use of independent contractors

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in healthcare is just very beneficial

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to both healthcare facilities
and to the professionals.

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Provides flexibility, cost savings,

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and it means that not
everybody has to be full-time.

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So it just creates a lot of flexibility.

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Also, it's often a higher wage rate.

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So freelance or independent contractor

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usually makes a higher amount of money

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than they do if they're a employee.

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But you know, what we're
gonna talk about this week

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it's for healthcare facilities
and healthcare professionals

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you really have to consider the legal

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and regulatory implications
of this relationship,

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including issues related to
insurance liability and taxes.

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But you know, you might be thinking about

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specifically liability.

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So that's one of the things we're going to

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dive into this week,

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and I'll see you in the discussion forum

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as we start talking about that.