150.000 HOSPITALS

150.955        Employed Physician Bill of Rights  

The Medical Society of the State of New York affirms the following as essential rights for physicians employed by a hospital or health care system or a member of a medical staff of a hospital or health care system:

Physicians employed by a Health Care organization (HCO) or a member of a medical staff of an HCO have the right to:

• Participate in the governance of the HCO,
• Participate in the operational and strategic planning of the HCO,
• Negotiate the conditions of employment,
• Negotiate the standards for quality, safety, privileging, peer review, and professional conduct,
• Establish medical staff by-laws and be able to select and remove medical staff leaders,
• Control the use of medical staff funds,
• Availability of independent legal counsel,
• Advocate for physicians and patients with any and all authorities without fear of retaliation from the HCO,
• Availability of adequate resources to provide for and improve patient care,
• Make treatment decisions, including referrals, based on the best interest of the patient, subject to review only by physician peers,
• Full due process before either the medical staff or the HCO takes any adverse action against a physician, and
• Full protection from any retaliatory action when participating in good faith peer review activities. (MSSNY Council March 11, 2024)

The Medical Society of the State of New York advocate that the organized medical staff of a hospital or health system maintain a meaningful role in any decision-making structure within such hospital or health system tasked with the evaluation of alleged behavioral or disciplinary issues of a physician who is part of the medical staff. (Reaffirmed and amended 2024 HOD – 51)

150.956        Medical Staff Credentialing for Physicians 

The Medical Society of the State of New York will advocate to the New York State Department of Health to revise existing regulations that would enable a three-year interval for the re-credentialing of health care professionals at hospitals instead of the current two-year interval. (HOD 2023-56)

150.957        NY Corporate Compliance Consolidation

MSSNY shall work with the NY DOH, NY Hospital Association, and other stakeholders to create a statewide minimum standard curriculum for corporate compliance education requirements, the completion of which is acceptable to all stakeholders.

MSSNY shall advocate for satisfactory completion of the new NY state approved standard corporate compliance curriculum at one setting to fulfill the requirements of all settings that require such a mandate, to eliminate wasting of valuable physician time and effort.

MSSNY will forward this policy to the AMA for consideration of adoption of a national level single corporate compliance curriculum acceptable in all settings. (HOD 2023-59)

150.958        Unintended Consequences of Value-Based Payment Models-Conflicts of Interest

The Medical Society of the State of New York will seek to amend the New York State Patient’s Hospital Bill of Rights to include the following patient rights:

1. The right, at all points in the patient’s care, to demand medical decisions that are informed by physicians.
2. The right to an unbiased medical opinion including information about treatments or services that are not reimbursed by the patient’s insurance company or may be better managed at another institution.

(HOD 2022-57 – partially adopted/Resolved 3 referred to Council; Reaffirmed HOD 2023 in lieu of Resolution 60)

150.959        Hospital Closures in Vulnerable Neighborhoods

Working together with county medical society leaders and patient advocacy groups, the Medical Society of the State of New York will advocate to key federal, state and local policymakers that meaningful local physician and patient input is ensured into proposals to close, downsize or re-purpose hospitals that could adversely impact health care options in communities served by those hospitals. MSSNY will advocate that the approval for closure, downsizing or repurposing of hospitals across the State ensure inclusion of public hearings in communities affected by the closure and public votes on such closures, downsizing or re-purposing. (HOD 2021-52)

150.960           Employed Physician Contracts

The Medical Society of the State of New York supports all employed physicians receiving all rights and due process protections afforded all other members of the Medical Staff.  This matter be taken to our AMA in support of all employed physicians.  (HOD 2021-AMA #2, referred to Council, adopted 4/15/21)

150.961        Transparency for ACA Plans and Contracting Hospitals

The Medical Society of the State of New York (MSSNY) will seek legislation/regulation such that the New York State Department of Health website lists both the plan and its contracting hospital(s).  MSSNY will seek legislation/regulation such that the ACA plan websites show the list of contracted hospitals and that ACA phone numbers also announce a list of contracted hospitals.  (HOD 2020-267)

150.962              Regulation of Hospital Advertising

The Medical Society of the State of New York and the AMA will advocate for regulation to promote responsible hospital and medical advertising. (HOD 2018-114)

150.963              NYS DOH Employment of Immediate Jeopardy for Surgical Attire

The Medical Society of the State of New York will urge the NYS Department of Health to reconsider its use of Immediate Jeopardy in alleged instances of lack of “proper” surgical attire and will advocate that measures that are less disruptive be used by the NYS DOH in order to ensure compliance with policies established by a hospital. (HOD 2018-110)

150.964             Pathology Specimens

The Medical Society of the State of New York will work with the Healthcare Association of New York State (HANYS) to ensure the development of hospital policies that give physicians appropriate discretion to determine which specimens should be sent for pathological analysis. (HOD 2018-65)

150.965            Adjusting Parameters for Hospital Readmission Reduction Program

The Medical Society of the State of New York will urge the Centers for Medicare and Medicaid Services (CMS) to omit planned and unrelated readmissions from the Hospital Readmissions Reduction Program. MSSNY supports implantation of hospital peer-grouping by CMS based on their similar proportions of low-income patients, rather than evaluating their performance on national levels.

MSSNY further supports a pilot study conducted by New York State to formulate appropriate testing criteria to ensure that the hospital readmission reduction program accounts for all the social factors and accurately reflects health quality delivered to our heart failure patients. (HOD 2018-252)

150.966                Hospital Closures: SUNSET HOD 2024

150.967             Taskforce on Hospital Mergers

The Medical Society of the State of New York will solicit relevant agencies to routinely engage MSSNY as a significant stakeholder in the evaluation of hospital mergers or closures regarding characteristics including, but not limited to:

1. Maintenance of patient choice and market competition
2. Cultural sensitivity and minority and community representation among key personnel
3. Compliance with MSSNY Position Statement 235.996
4. Provision of charity care consistent with the designation as a non-profit
5. Assurance of adequate access to primary and subspecialty care
6. Ability to achieve and maintain high scores on measures of patient satisfaction, patient safety and quality metrics
7. Preservation of the continuity of the physician-patient relationship
8. Effect on graduate and undergraduate medical education. (HOD 2014-201)

150.968               Operating Room Quiet Zones: SUNSET HOD 2022

150.969               Stop Closure of Kingsboro Psychiatric Center as Recommended by the Berger Commission

MSSNY will advocate that Kingsboro Psychiatric Center in Brooklyn stay open and not move to South Beach Psychiatric Center in Richmond County for the best interests of the patients and their families. (HOD 2012-113; Reaffirmed HOD 2022)

150.970           Compensation for Emergency Department Coverage: 

MSSNY recommends that hospitals utilizing voluntary physicians to provide coverage for emergency departments provide appropriate compensation for these services in a manner consistent with Advisory Opinions issued by the Office of the Inspector General (OIG) and, also, that voluntary physicians should not be required by hospitals to provide emergency department coverage without compensation.  (HOD 2011-111; Reaffirmed HOD 2021)

150.971           HHS and Hospital-Acquired Conditions: (HOD 2008-258; SUNSET HOD 2018)

150.972           Gain-sharing:  (HOD 2008-206; SUNSET HOD 2018)

150.973           Unified System for Hospital Re-credentialing in New York State:

MSSNY will work for legislation requiring all New York State hospitals to use the same standard re-credentialing form, and require the same standard data and/or materials for re-credentialing.

MSSNY will work for legislation providing that hospital re-credentialing forms should require the physician to fill out only information that has changed since the previous submission.  (HOD 2002-269; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

150.974           Hospital Overcrowding; Developing Statewide Solutions:

MSSNY will urge the New York State Department of Health, with input from MSSNY and other interested parties, to analyze data on hospital overcrowding, and make this data available for local initiatives, including public relations and media tactics, and other efforts to mitigate the hospital overcrowding problem.  (HOD 2002-78; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

150.975           MSSNY to Take All Appropriate Measures to Facilitate Transfers of on-acute Patients to Physicians’ Offices:

MSSNY should take all appropriate measures to allow hospital emergency departments to facilitate the transfer of non-acute patients to physicians’ offices in appropriate situations.  (HOD 2000-77; Reaffirmed HOD 2014; Reaffirmed HOD 2019 in lieu of res 57)

150.976           Opposition to the Criminalization of the Infractions of State Statutes and Regulations Regarding Post Graduate Supervision and Staffing:

MSSNY will notify all teaching hospitals of the importance of adherence to the requirements of State Statutes and Regulations regarding Post Graduate Supervision and Staffing. MSSNY shall continue to oppose the Criminalization of good faith medical judgment, and each teaching institution required to comply with State Statutes and Regulations Regarding Post Graduate Supervision and Staffing regulations shall provide on a yearly basis a copy of those regulations to each house officer and each attending physician. (HOD 1999-172; Reaffirmed HOD 2014)

150.977          Prohibit Institutions from Mandating In-House Testing:

MSSNY will seek measures to prohibit mandatory in-hospital pre-operative testing when those tests, including but not limited to blood and urine, EKGs, chest X-rays, etc are performed in a qualified physician’s office or in a state-and/or CLIA-accredited facility. (HOD 1998-126; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

150.978          For Profit Hospitals and Nursing Homes:

MSSNY will vigorously support current law prohibiting for-profit businesses from entering the New York hospital and nursing home market. (Council 12/18/97; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

150.979          In-House Testing, Prohibition of Institutions from Mandating:

MSSNY believes that institutions should allow physicians to perform any mandated pre-operative testing outside the institution and will encourage institutions to adopt this policy. (HOD 1996-126; Reaffirmed 2014)

150.980         Services, Provision of on a Seven Day A Week Basis:

MSSNY supports the provision of all appropriate services on a seven day a week basis to assure timely evaluation treatment and safe discharge of patients and will encourage hospitals to comply with this policy. (HOD 1996-127; Reaffirmed HOD 2014)

150.981        Maternity and Family Leave for Hospital Medical Staff, Including Residency Programs in New York State:

The position of the Medical Society of the State of New York regarding leave policies for physicians in practice or residency training includes as follows:

(a) MSSNY urges medical schools, residency training programs, medical specialty boards, the Accreditation Council on Graduate Medical Education and medical group practices to incorporate and/or encourage development of written leave policies including parental leave, family leave and medical leave;

(b) Residency program directors and group practice administrators should review federal and state law for guidance in developing policies for parental, family and medical leave;

(c) Physicians who are unable to work because of disability due to pregnancy, childbirth and other related medical conditions should be entitled to such leave and other benefits on the same basis as other physicians who are temporarily disabled for other medical reasons; (d) Residency programs and group practices should develop written policies on parental leave, family leave and medical leave for physicians. Such written policies should include the following elements:

leave policy for birth or adoption;

duration of leave allowed before and after delivery;

category of leave credited (e.g. sick, vacation, parental, unpaid leave, short term disability);

whether leave is paid or unpaid;

whether provision is made for continuation of insurance benefits during leave and who pays for premiums;

whether sick leave and vacation time may be accrued from year to year or used in advance

Residency program policies should also include:

extended leave for resident physicians with extraordinary and long-term personal or family medical tragedies for period of up to one year without loss of previously accepted residency positions, for devastating conditions such as pregnancy which threaten maternal or fetal life;

how time can be made up in order to be considered board eligible;

whether make-up time will be paid;

what period of leave would result in a resident physician being required to complete an extra or delayed year of training;

whether schedule accommodations are allowed, such as reduced hours, no night call, modified rotation schedules and permanent part-time scheduling.

(e) Staffing levels and scheduling are encouraged to be flexible enough to allow for coverage without creating intolerable increases in other physicians’ workloads, particularly in residence programs; and (f) Physicians should be able to return to their practices or training programs after taking parental leave, family leave or medical leave without the loss of status. (Council 3/9/95; Amended HOD 1997-180; Reaffirmed HOD 2014)

150.982             Guidelines Regarding the Role of Medical Directors in New York State:

MSSNY supports the following Guidelines Regarding the Role of the Hospital Medical Director:

(1) The hospital governing body, management and medical staff should jointly determine if there is a need to employ a medical director; establish the purpose, duties, and responsibilities of this position; establish the qualifications for this position; and provide a mechanism for medical staff input into the selection, evaluation and termination of the hospital medical director;

(2) The organized medical staff should maintain overall responsibility for the quality of the professional services provided by individuals with clinical privileges and should have the responsibility of reporting to the governing body; and

(3) Government regulations which mandate that a hospital medical director has authority over the medical staffs should be repealed.

MSSNY will seek modification of existing laws and regulations consistent with these guidelines. (HOD 1995-72; Reaffirmed HOD 2014)

150.983             Faculty/Staff Appointments at Medical Schools:

MSSNY supports having the New York State Department of Health develop regulations or legislation that would prevent a hospital from requiring a member of its voluntary staff to resign or accept a faculty appointment at a medial school as a condition of appointment to the medical staff, and is petitioning the New York State Department of Education to take all steps necessary to encourage the development of an adjunct faculty line at each medical school which would permit physicians to hold more than one medical school faculty appointment. (HOD 1993-131; Modified and reaffirmed HOD 2014)

MSSNY adopted the policy that it is inappropriate for any hospital to require a member of its voluntary staff to resign a faculty appointment at a medical school as a condition of appointment or reappointment. MSSNY supports the development of an adjunct faculty line at each medical school in New York State that could be used to permit physicians to hold more than one medical school faculty appointment. It has adopted as policy that it is inappropriate for a hospital or medical school to deny a physician an appointment or reappointment to its voluntary staff because that physician already holds a position at another medical school. (HOD 1992-88; Reaffirmed HOD 2014)

150.984              Outpatient Medical Services:

MSSNY is seeking legislation to provide that practitioners whose practices are supported, sponsored by and financially beneficial to hospital controlled satellite diagnostic and therapeutic facilities be held to the same self-referral standards to which the community-based practitioners are held. (HOD 1993-77; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

150.985             Incident Reports:

MSSNY is working with the Hospital Association of New York State to ensure that a copy of a hospital incident report which has been forwarded to the New York State Department of Health be sent to any physician whose name is included in such incident report. MSSNY is seeking to ensure that physician identifying information included in hospital incident reports submitted to the New York State Department of Health remain confidential and not be publicly disclosed, as well as seeking to ensure that all information developed by review of incidents required to be reported including, but not limited to “Statements of Deficiency” be covered under existing New York State confidentiality statutes and not be subject to disclosure through the Freedom of Information Law (FOIL). (HOD 1992-40; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

150.986           Physical Examination for Physicians (Annual):

MSSNY continues to meet with the Department of Health and other interested parties to clarify existing issues pertaining to the physical examination requirements under Section 405.(b)(10) of the Health Department regulations. MSSNY takes the following position with regard to the physical examination requirements:

(1) Physicians should have the option of going to his/her personal physician for the physical examination;

(2) If the physician opts to have the physical examination performed by the personal physician, the medical records pertaining to the physical examination should be retained in the office of the personal physician.

(3) The attestation form which the hospital must retain to document the physical examination should be standardized.

MSSNY should be involved in the development of an attestation form. (HOD 1991-91; Reaffirmed HOD 2014; Reaffirmed HOD 2024)

150.987                 Medical Staff Involvement in Development of Plan of Correction:

MSSNY adopted the policy that a hospital medical staff must be appropriately involved in the development of a “Plan of Correction” as it pertains to the medical staff. Such involvement should be consistent with existing hospital medical staff Bylaws, rules and regulations. Hospital medical staffs were encouraged to amend their Bylaws, if necessary, to establish a procedure to ensure appropriate medical staff input into the development of a “Plan of Correction.” (HOD 1991-105; Reaffirmed HOD 2014)

150.988           Economic Credentialing and Medical Staff Privileges:

It is the position of MSSNY that:
(1)  No hospital or ambulatory facility shall curtail, restrict, or terminate the medical staff privileges of any physician without adherence to established procedures set forth in the medical staff Bylaws, and only after the accordance of due process rights pursuant to the procedures specified in the Federal Health Care Quality Improvement Act of 1986, or in accordance with provisions of the hospital or ambulatory facility medical staff Bylaws; and  (2)  No hospital or ambulatory facility shall curtail, restrict, or terminate the medical staff privileges of any physician based upon economic criteria unrelated to the quality of patient care; and

(3)  No hospital ambulatory facility shall solicit, require, or accept any payment as direct or indirect consideration for the awarding or granting by the hospital or ambulatory facility of the right to exercise medical staff privileges.  This prohibition shall not apply to required payment of medical staff dues or medical society dues that may be required of all members of the hospital or ambulatory facility medical staff.  (HOD 92-33; reaffirmed HOD 2014)

MSSNY’s Hospital Medical Staff Section developed a MSSNY Policy Paper on Economic Credentialing and Exclusive Contracts which was approved by Council on July 23, 1992.  The Policy Paper is available, upon request, at the Society Headquarters in Lake Success.  MSSNY affirmed the concept that the credentialing of physicians for medical staff appointment or reappointment should be based solely on issues of competency, training and quality of patient care.  The Society is seeking regulatory or legislative remedies to assure that only those with appropriate medical training, experience and ongoing clinical expertise will have the ability to establish standards of care and measure practice by these standards.  MSSNY has communicated to the Hospital Association of the State of New York, its component associations and all other appropriate and interested parties its concern over the use of an individual physician’s economic performance data which is being generated by hospitals in an effort to link charges, cost and clinical outcome as a major parameter, in and of itself, for the purposes of credentialing and re-appointing physicians.  Hospital medical staff physicians and their leadership were informed by MSSNY to take precautions against any hospital initiative aimed at restructuring medical staff Bylaws which would emphasize economics and which could ultimately undermine quality of care.  (HOD 1991-67; Reaffirmed HOD 2014; Reaffirmed in lieu of HOD 2020-66)

150.989               Governing Boards – Medical Staff Physician Representation:

In light of recent changes to revised New York State Hospital Code (Part 405) and the resulting increase of hospital governing boards’ focus on quality assurance and clinical resource allocation, the Medical Society of the State of New York reaffirmed its positions and urged hospitals in New York State to appoint active medical staff members as full voting staff members of hospital governing boards.  (HOD 1990-20; Reaffirmed HOD 2013)

MSSNY is seeking enactment of legislation specifically authorizing physicians who are members of the medical staffs of municipal hospitals to serve on the governing body of such municipal hospitals, and is encouraging physicians who are members of medical staffs of all hospitals to seek to serve on the governing bodies of their hospitals.  (HOD 1988-82; Reaffirmed HOD 2013)

MSSNY recognizes the essential close working relationship that must exist between hospital governing bodies and medical staffs to ensure the delivery of optimal quality medical care to all patients served by hospitals.  To accomplish this, MSSNY strongly endorses the concept of practicing physician representatives from the medical staffs serving on hospital governing boards with voice and vote, to provide expertise and guidance concerning the development of medical care priorities.  (Council 11/14/85; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

150.990                    Certificate of Need:

MSSNY has insisted on the elimination of the technique utilized by the New York State Department of Health of withholding or delaying Certificates of Need from hospitals (and other institutions) until compliance with other State Health Department regulations is obtained.  It is the position of MSSNY that the public be advised of the medical profession’s concern about this abuse of authority.  (HOD 1989-15; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

150.991                  Physician Credentialing: SUNSET HOD 2013

150.992                 Bed Reductions: SUNSET HOD 2023

150.993                 Newborn – Resuscitation of: SUNSET HOD 2013

150.994                 Termination of Hospital Privileges Based on Age of Physician:

MSSNY opposes mandatory termination of hospital privileges based solely upon the age of the physician, and takes the position that age should not be used as a criterion in judging the character or competency of the physician.  (HOD 1986-23; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

150.995               Preadmission Review:

MSSNY is in agreement with the American Medical Association policy to oppose mandated blanket hospital preadmission review for all patients, or for specified categories of patients, by government, other payors or hospitals, while encouraging physician-directed peer review organizations to consider the implementation of focused preadmission review on a voluntary basis.  The MSSNY promulgated the following sample Guidelines for all third party payors or insurers in the matter of preadmission certification and review in this State Preadmission Certification and Review Guidelines:

(1)  The physician/patient relationship must remain intact and must not be disturbed by interference from any entity, including third party insurer.

(2)  The quality of health care delivered must remain at the highest level and not be affected by health insurance mandated policies and procedures.

(3)  There shall be direct and continuing communications by health insurers to physicians and insureds regarding prior authorization requirements; it shall be the responsibility of the insured or insurer to notify physicians when there are any pre-authorization or other technical contract requirements connected with the rendering of specific services.

(4)  In situations where the diagnosis, proposed plan of treatment, and anticipated length of hospital stay is questioned, it must be discussed only between the treating physician and a physician representing the third party carrier.

(5)  After thorough review of all submitted medical information, if the insurer’s physician disagrees with the certification request, be it the rule that the patient’s physician be allowed a consultation with the insurer’s consulting physician prior to any adverse decision.  The attending physician should be given the opportunity to provide additional medical information to substantiate the request for hospital admission.  If the patient’s physician disagrees with the initial consultation, be it the rule that a request for a second consultation be granted by the health insurer.  (Under these circumstances, further monetary penalties, i.e., reduced benefits, should not be imposed on the insured because of physician’s request for a second consultant.)  However, it is understood that reduced benefits may be imposed by the insurer if the patient does not adhere to the preadmission certification requirement to obtain a second opinion.

(6)  Physician-to-physician contact be the rule when there is disagreement between a treating physician’s plan of treatment and insurance company guidelines.  If there is a change of treatment plan, the insurer must give the treating physician ample time to notify his/her patient of such change.  Further, where disagreement exists between the physician and the insurer as to anticipated length of stays and preadmission certification, ample time must be allowed for the attending physician to apprise the patient that his/her contract may or may not provide full benefits for the prescribed plan of treatment, and any ensuing costs for the services provided may become the patient’s responsibility.

(7)  Since patients who inadvertently do not request required pre-admission and length of stay certification for services performed may be subject to reduced benefit payments, they must have right of appeal.

(8)  When emergency hospitalization is required, up to 48 hours (i.e., two business days, following the patient’s admission) must be allowed for the purpose of certification.

(9)  Health insurers must also be responsive to the desires of the State and local medical community concerning input into the establishment of criteria for preadmission certification programs.

(10)  In view of the significant increase in New York State health insurance plans requiring Preadmission Certification Programs, salient features of these programs, such as second surgical opinions, concurrent length of stays, and confirmation of emergency admissions, be implemented uniformly in order to mitigate confusion among the patient and physician community in such a way as to conform to the basic principles outlined in the foregoing Guidelines.  (HOD 1986-11; Amended Council 2/12/87; Amended HOD 3/14/87; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

150.996                    Professional Misconduct, Notification by Hospital to Accused Physician:

Any committee of a hospital that is duly constituted by the hospital to review matters involving professional misconduct should provide a physician who is accused of misconduct with notice of the charges, an opportunity to be heard, and any other safeguards that may be provided by the Bylaws.  The committee is required to report to the Board for Professional Medical Conduct only if it has information which reasonably shows that the physician is guilty of professional misconduct as defined by section 6530 of the Education Law.  (Joint Position of MSSNY and HANYS approved by Council 11/14/85; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

150.997           Admitting Privileges: 

MSSNY supports the policy that hospitals should continue to offer equal hospital admitting privileges and equal access to beds to qualified physicians on their staff regardless of the physician’s choice of reimbursement mechanisms or their financial arrangements with their hospital.  (HOD 1982-58; Reaffirmed HOD 2013; Reaffirmed in lieu of HOD 2020-66))

150.998                 Attending Physicians and Residents, Guidelines For:

MSSNY adopted the following statement as part of its official position. It is a supplement to the Guidelines for Attending Physicians and Residents Established by the New York Academy of Medicine.  Because optimum care of hospitalized patients often entails technically sophisticated treatment modalities, reliance on the expertise of specialists and consultants, and frequent clinical assessments and judgments by house officers or other designees of the attending physician, it is imperative to specifically indicate the authority and responsibility for decisions about treatment and management.  Ethically and legally, the patient’s freely selected attending physician possesses this authority and responsibility.  Such action will strengthen the patient-physician relationship essential to the continuity of a patient’s care.  The patient’s own physician clearly retains ultimate responsibility for patient management but close cooperation between his/her own physician and the involved house officers and specialist consultants is essential to provide the highest quality of patient care.  Features of this cooperation should include at least the following:

(1)  Ongoing discussions and review of the patient’s course by the attending and other involved physicians.

(2)  Explicit approval and/or supervision by the amending of invasive, hazardous, or complex diagnostic or treatment procedures.

(3)  Explicit approval by the attending physician of the indications or requests for consultations, and of the choice of consultant.

(4)  Recognition by the attending physician to contribute to the education, training and learning experience of the house staff.

(5)  Conscientious efforts by the house staff and other involved physicians prompted to inform the attending physician of unexpected changes in the patient’s condition or needs for treatment.

(6)  Although there is recognition by both attendees and house officers that they share responsibility for writing orders, recording observations, or formulating analyses or treatment goals in the progress notes, the ultimate authority for patient care is the patient’s attending physician.*

These guidelines will best serve the goal of optimum care for the patient and will enhance the quality training for young physicians.  The attending physicians, hospital administrations, and house officers have the obligation to respect these guidelines and the attending physician shall candidly inform the patient of the roles of the various physicians in that patient’s care.  In such explanations, the patient’s right freely to select his/her own physician must be maintained.  No assignment of attending physician shall be made without prior discussion of available options with the patient and then only with his/her full knowledge and freely given consent.  (HOD 1982-51; Reaffirmed HOD 2013; Reaffirmed HOD 2023)

The Guidelines of the New York Academy of Medicine are available, upon request, at the Society Headquarters in Westbury.

NB:         Per General Counsel, this position statement was cited in the dissenting opinion in Somoza v. St. Vincent’s Hospital 596 N.Y.S. 2d 789 (App. Div., 1st Dept., April 22, 1993).  The majority decision nevertheless held that a hospital and a hospital resident may be held legally responsible where the hospital resident carries out the order of a private attending physician but knows, or should know, that the physician’s orders “are so clearly contraindicated by normal practice that ordinary prudence require inquiry into correctness of the order.”  The ruling, according to the majority decision, is an exception to the general rule followed by the courts which holds that the hospital and the hospital staff cannot be held legally responsible for the actions of a private attending physician as long as the hospital staff properly carries out the attending physician’s orders. (Reaffirmed HOD 2024)

150.999                      Medical Staff Criteria:

The policy of the Medical Society of the State of New York is that admission to a hospital medical staff should be on an individual basis, after an impartial review of the applicant’s qualifications by the medical staff credentialing committee.  Such impartial review should serve as the basis for the hospital Board of Trustees’ final determination upon request for appointment to the medical staff, and that membership in any group affiliated with the hospital shall be a substitute for review of the individual’s qualifications.  (HOD 1980-25; Amended Council 1/22/81; Reaffirmed HOD 2013; Reaffirmed HOD 2023)