Bylaws

ARTICLE III - CATEGORIES OF MEMBERSHIP

 3.1            CATEGORIES

The categories of the medical staff shall include the following: active, courtesy, consulting, provisional, emeritus. At each time of reappointment, the member's staff category shall be determined.

3.2             ACTIVE STAFF

3.2-1 QUALIFICATIONS

The active staff shall consist of members who:

(a)               meet the general qualifications for membership set forth I Section 2.2;

(b)               have offices or residences which, in the opinion of the Medical Executive Committee, are located closely enough to the hospital to provide appropriate continuity of quality care, or otherwise demonstrate to the satisfaction of the Medical Executive Committee that he or she can provide adequate coverage to render quality of care appropriate to patient needs;

(c)               regularly involved in diagnosis or treatment of 10 or more patients per year prior to, during or after admission to the hospital.

(d)               Except for good cause shown as determined by the medical staff, have satisfactorily completed their designated term in the provisional staff category.

3.2-2 PREROGATIVES

Except as otherwise provided, the prerogatives of an active medical staff member shall be to:

(a)               admit patients and exercise such privileges as are granted pursuant to Article V;

(b)       attend and vote on matters presented at general and special meetings of the medical staff and of the department and committees to which the member is duly appointed; and hold staff, division, or department office and serve as a voting member of committees to which the member is duly appointed or elected by the medical staff or duly authorized representative thereof subject to the rules and regulations of the physician's department.

            3.2-3 TRANSFER OF ACTIVE STAFF MEMBER

After two consecutive years in which a member of the active staff fails to regularly care for patients in this hospital or be regularly involved in medical staff functions as determined by the medical staff, that member shall be automatically transferred to the appropriate category, if any, for which the member is qualified unless determined by the Medical Executive Committee.

3.3             THE COURTESY MEDICAL STAFF

3.3-1 QUALIFICATIONS

The courtesy medical staff shall consist of members who:

(a)               meet the general qualifications set forth in subsections (a)-(b) or Section 3.2-1;

(b)               do not regularly care for or are not regularly involved in medical staff functions as determined by the medical staff (admit, or regularly care for (or participate in the care of) not more than 10 patients in the hospital;

(c)               are members in good standing of the active medical staff of another California licensed hospital, although exceptions to this requirement may be made by the Medical Executive Committee for good cause; and

(d)               have satisfactorily completed appointment in the provisional category.

3.3-2      PREROGATIVES

Except as otherwise provided, the courtesy medical staff member shall be entitled to:

(a)               admit patients to the hospital with the limitations of Section 3.3-1(b) and exercise such privileges as are granted pursuant to Article V; and

(b)               attend in a non-voting capacity meetings of the medical staff and the department of which the individual is a member, including open committee meetings and educational programs, but shall have no right to vote at such meetings, except within committees when the right to vote is specified at the time of appointment.

Courtesy staff members shall not be eligible to hold office in the medical staff.

3.3-3      LIMITATION

Courtesy staff members who admit patients or regularly care for patients at the hospital shall, upon review of the Medical Executive Committee, be automatically transferred to the appropriate staff category.

3.4       PROVISIONAL STAFF       

            3.4-1 QUALIFICATIONS

            The provisional staff shall consist of members who:

(a)               meet the general medical staff membership qualifications set forth in Sections 3.2-1(a) and (b) or 3.4-1(a)-(d); and

(b)               immediately prior to their application and appointment were not members (or were no longer members) in good standing of this medical staff.

3.4-2 PREROGATIVES

The provisional staff member shall be entitled to:

(a)               admit patients and exercise such privileges as are granted pursuant to Article V; and

(b)               attend meetings of the medical staff and the department of which that person is a member, including open committee meetings and educational programs, but shall have no right to vote at such meetings, except within committees when the right to vote is specified at the time of appointment. Provisional staff members shall not be eligible to hold office in the medical staff organization, but may serve upon committees.

3.4-3 OBSERVATION OF PROVISIONAL STAFF MEMBER

Each provisional staff member shall undergo a period of observation by designated monitors as described in Section 5.3. The purpose of observation shall be to evaluate the member's (1) proficiency in the exercise of privileges initially granted and (2) overall eligibility for continued staff membership and advancement within staff categories. Observation of provisional staff members shall follow whatever frequency and format each department deems appropriate in order to adequately evaluate the provisional staff member including, but not limited to, concurrent or retrospective chart review, mandatory consultation, and/or direct observation and should be a broadly representative of the individual practice. Appropriate records shall be maintained. The results of the observation shall be communicated by the department chair to the Medical Executive Committee.

3.4-4 TERM OF PROVISIONAL STAFF STATUS

A member may remain in the provisional staff for a period of at least one year but not to exceed two years. The provisional staff status may not be shorter than one year.

3.4-5      Action shall be initiated to evaluate and possibly terminate the privileges and membership of a Provisional member who does not qualify within two (2) years for advancement to another staff category.

3.4-6      ACTION AT CONCLUSION OF PROVISIONAL STAFF STATUS

(a)               If the provisional staff member has satisfactorily demonstrated the ability to exercise the privileges initially granted and otherwise appears qualified for continued medical staff membership, the member shall be eligible for placement in the active, courtesy or consulting staff as appropriate, upon recommendation of the Medical Executive Committee; and

(b)               In all other cases, the appropriate department shall advise the Medical Executive Committee which, in turn, shall make its recommendation to the Board of Directors regarding a modification or termination of privileges or termination of medical staff membership.

3.5       THE CONSULTING MEDICAL STAFF

            3.5-1 QUALIFICATIONS

Any member of the medical staff in good standing may consult in that member's area of expertise; however, the consulting medical staff shall consist of such practitioners who:

(a)               are not otherwise members of the medical staff and meet the general qualifications set forth in Section 2.2, except that this requirement shall not preclude an out-of-state practitioner from appointment as may be permitted by law if that practitioner is otherwise deemed qualified by the Medical Executive Committee;

(b)               possess adequate clinical and professional expertise;

(c)               are willing and able to come to the hospital on schedule or promptly respond when called to render clinical services within their area of competence;

(d)               are members of the active or courtesy medical staff of another hospital licensed by California or another state, although exceptions to this requirement may be made by the Medical Executive Committee for good cause; and

(e)               have satisfactorily completed appointment in the provisional category.

3.5-2 PREROGATIVES

The consulting medical staff member shall be entitled to:

(a)               exercise such clinical privileges as are granted pursuant to Article V; and

(b)               attend meetings of the medical staff and the department of which that person is a member, including open committee meetings and educational programs, but shall have no right to vote at such meetings, except within committees when the right to vote is specified at the time of appointment. Consulting staff members shall not be eligible to hold office in the medical staff organization, but may serve committees.

3.6       THE EMERITUS STAFF

            3.6-1 QUALIFICATIONS

            The Emeritus Staff

                        The Emeritus staff shall consist of either:

(a)               physicians, dentists or podiatrists who do not actively practice at the hospital but are deemed deserving of membership by virtue of their outstanding reputation, noteworthy contributions to the health and medical sciences, or their previous long-standing service to the hospital, or

(b)               members, who have retired from active practice and, at the time of their retirement, were members in good standing of the active medical staff for a period of at least five continuous years, and who continue to adhere to appropriate professional and ethical standards.  The emeritus staff shall not be subject to reappraisal or reappointment.

3.6-2 PREROGATIVES

Emeritus and retired staff members are not eligible to admit patients to the hospital or to exercise privileges in the hospital, or to vote or hold office in this medical staff organization, but they may serve upon committees with or without vote at the discretion of the Medical Executive Committee. They may attend staff and department meetings, including open committee meetings and educational programs.

3.7             TEMPORARY STAFF

3.7-1 QUALIFICATIONS

The Temporary Staff shall consist of physicians, dentists or podiatrists who do not actively practice at the hospital but are important resource individuals for medical staff quality assurance activities. Such persons shall be qualified to perform the functions for which they are made temporary members of the staff.

3.7-2 PREROGATIVES

Temporary medical Staff members shall be entitled to attend all meetings of committees to which they have been appointed for the limited purpose of carrying out quality assurance functions. They shall have no privileges to perform clinical services in the hospital. They may not admit patients to the hospital, or hold office in the medical staff organization, They may, however, serve on designated committees with or without vote at the discretion of the Medical Executive Committee. Finally, they may attend medical staff meetings outside of their committees, upon invitation.

3.8             ADMINISTRATIVE STAFF

3.8-1 QUALIFICATIONS

Administrative Staff category membership shall be held by any physician who is not otherwise eligible for another staff category and who is retained by the hospital and medical staff solely to perform ongoing medical administrative activities.

The administrative staff shall consist of members who:

(a)               are charged with assisting the medical staff in carrying out medical-administrative functions, including but not limited to quality assurance and utilization review;

(b)               document their (1) current licensure, (2) adequate experience, education and training, (3) current professional competence, (4) good judgment, and (5) physical and mental health status, so as to demonstrate to the satisfaction of the medical staff that they are professionally and ethically competent to exercise their duties;

(c)               are determined (1) to adhere to the ethics of their respective professions, (2) to be able to work cooperatively with others so as not to adversely affect their judgment in carrying out the quality assurance functions, and (3) to be willing to participate in and properly discharge those responsibilities determined by the medical staff.

3.8-2 PREROGATIVES

The administrative staff shall be entitled to:

Attend meetings of the medical staff and various departments, at the invitation of the chair, including open committee meetings and educational programs, but shall have no right to vote at such meetings, except to the extent the right to vote is specified at the time of appointment.

Administrative staff members shall not be eligible to hold office in the medical staff organization, admit patients or exercise privileges.

3.9             HOUSE STAFF

3.9-1 QUALIFICATIONS

Resident medical staff membership shall be held by post-doctoral trainees (residents or fellows) in training programs of teaching institutions who are not eligible for another staff category and who are either licensed or registered with the appropriate State of California licensing board. All resident medical staff members must obtain a license to practice medicine within the State of California when eligible.

3.9-2 APPOINTMENT

(a)               Post-doctoral trainees who are enrolled in accredited residency training programs and who meet the above qualifications shall be appointed to the resident medical staff. members of the resident staff are not eligible to hold office within the medical staff, but may participate in the activities of the medical staff through membership on medical staff committees, with the right to vote within committees if specified at the time of appointment, and non-voting attendance at medical staff meetings.

(b)               All medical care provided by resident medical staff is under the supervision of members of the active, courtesy or consulting staff.

(c)               Appointment to the resident medical staff shall be for one year and may be renewed annually. Resident medical staff membership may not be considered, as the observational period required to be completed by provisional staff. Resident medical staff membership terminates with termination from the training program.

(d)               The supervising physician shall sign all procedures and orders within a 48-hour period. Monitoring of the resident staff shall include a monthly report to their respective clinical department on the activity performed by each individual resident.

3.10         LIMITATION OF PREROGATIVES

The prerogatives set forth under each membership category are general in nature and may be subject to limitation by special conditions attached to a particular membership, by other sections of these bylaws and by the Medical Staff Rules and Regulations.

3.11         GENERAL EXCEPTIONS TO PREROGATIVES

Regardless of the category of membership in the medical staff, limited license members:

(a)               shall only have the right to vote on matters within the scope of their licensure. In the event of a dispute over voting rights, that issue shall be determined by the chair of the meeting, subject to final decision by the Medical Executive Committee; and

(b)               shall exercise privileges only within the scope of their licensure and as set forth in Section 5.4.

3.12         MODIFICATION OF MEMBERSHIP

On its own, upon recommendation of the clinical department, or pursuant to a request by a member under Section 4.6-1(b), or upon direction of the Board of Directors as set forth in Section 6.1-6, the Medical Executive Committee may recommend a change in the medical staff category of a member consistent with the requirements of the bylaws.