Jonathan H. Burroughs, MD, MBA, FACHE, FAAPL, is President and CEO of The Burroughs Healthcare Consulting Network, Inc., and works with some of the nation’s top healthcare consulting organizations to provide ‘best practice’ solutions and training to healthcare organizations throughout the country in the areas of governance, physician–hospital alignment strategies, credentialing, privileging, peer review and performance improvement/patient safety, medical staff development planning, strategic planning, physician performance, and behavior management as well as ways in which physicians and management can work together in new ways to solve quality, safety, operational, and financial challenges.
Litigation Support: Dr. Burroughs offers litigation support services to counsel representing both Plaintiff and Defense. He provides general expert witness services for cases involving:
Negligent Peer Review
Physician Performance Management
Fraud and Abuse
Fair and Judicial Hearings
Medical Staff Bylaws, Policies, Procedures, Rules & Regulations
Dr. Burroughs serves on the national faculty of the American College of Healthcare Executives and the American Association for Physician Leadership (formerly the American College of Physician Executives), where he has been consistently rated as one of their top speakers and educators. He and Dr. David Nash were recently awarded a development grant by the American College of Healthcare Executives (ACHE) to develop a twelve hour national program to address population health and the disruptive innovative business models necessary to support it. He is the author or coauthor of the following books: Redesign the Medical Staff Model-A Collaborative Approach (published by Health Administration Press, January, 2015), The Complete Guide to FPPE (2012), Medical Staff Leadership Essentials (2011), Engage and Align the Medical Staff and Hospital Management: Expert Strategies and Field Tested Tools (2010), A Practical Guide to Managing Disruptive and Impaired Physicians (2010), The Top 40 Medical Staff Policies and Procedures, Fourth Edition (2010), Emergency Department On-Call Strategies: Solutions for Physician-Hospital Alignment (2009), and Peer Review Best Practices: Case Studies and Lessons Learned (2008).
Dr. Burroughs is a former Senior Consultant and Director of Education Services for The Greeley Company where he was rated as one of their top healthcare consultants and educators over an eight year period. He is also a past medical staff president, past president of the New Hampshire chapter of the American College of Emergency Physicians, and served as an emergency department medical director. As a member of the governing board of Memorial Hospital in New Hampshire, he chaired the ethics, succession planning, and bylaws committees and sat on the joint conference, strategic planning, and medical executive committees. He previously served as a member of the clinical faculty of Dartmouth Medical School, where his research interests included introducing EMT defibrillation and automatic defibrillation into the field.
Population health is not possible in a discounted fee-for-service world, and the significant healthcare business challenge is how to transition from fee-for-service to risk-based capitation in a sustainable way. The following represents an outline for how this transition can be staged so that early steps exploit the benefits of fee-for-service while the latter ones exploit a more capitated model:
Not too long ago, I had the sad task of testifying at a civil litigation and a judicial hearing for two physicians who had been suspended from their respective medical staffs. In both cases, the suspensions and resultant procedural rights were avoidable because proactive communication and management did not effectively take place. Such events should be rare and most medical staffs can easily avoid them by focusing on preventive actions and addressing potential performance issues early in a supportive and assertive manner.
Hospital CEOs may have once cast a wary eye when a retail clinic opened in their backyard, but that paradigm has shifted as health systems are increasingly opening their own retail clinics or affiliating with retail clinic operators.
Regulatory hurdles prevent more hospitals from using e-health to its full potential. Federal and state policies and regulations on care rendered via technology from a remote site spin a tangled web for providers either engaged in e-health or who want to be. A February 2014 article in Health Affairs found strong associations between state policies and hospitals' adoption of e-health, also known as tele-health or telemedicine.
Alarm fatigue has moved to the forefront of hazards on the hospital floor. Nursing staff gets bombarded by hundreds or thousands of beeps, rings, whistles and pings emanating from bedside devices in a shift, and it can be difficult for them to distinguish the critical from the routine. An analysis of hospital alarms at Johns Hopkins Hospital counted a total of 59,000 alarms over a 12-day observation period, an average of 350 alarms per patient per day.1
In this book, the author, an experienced physician leader and healthcare consultant, describes key changes that must be made to redesign the medical staff model. He provides specific guidance and examples to help healthcare leaders and executives work with their physician leaders to face these changes successfully. Well-regarded contributors and subject matter experts offer additional examples and insights with special content throughout the book.
The Complete Guide to FPPE provides step-by-step guidance for developing an FPPE process and policy, selecting indicators, collecting data, conducting performance conversations with practitioners, and managing FPPE for low-volume and advance practice practitioners.
Sharpen medical staff leadership skills with proven educational strategies and succession planning tools. Medical Staff Leadership Essentials: A Guide to Developing Leadership Skills and Recruiting the Next Generation delivers a step-by-step process for becoming an effective physician leader and training future leaders. Veteran and new physician leaders alike will gain valuable insight to help the medical staff develop, retain, and recruit a legacy of effective physician leaders.
Real-world solutions to problem physician behavior Don t let disruptive physician behavior and impairment negatively affect your hospital s operations or put your patients, staff, and colleagues at risk. This resource will help you implement a sound program to manage impairment and prevent disruptive physician behavior.
This resource combines the expertise of advisors from The Greeley Company and in-the-trenches hospital and medical staff leaders. You ll get real-world solutions to engage practitioners in medical staff activities and align them with hospital goals. Unlike other theory-based books, this resource provides tools and strategies that have helped your peers break the cycle of disengagement and apathy.
Developed by trusted Greeley Company experts, the fourth edition of this concise guide will help you develop medical staff policies and procedures that comply with Joint Commission requirements and promote current industry best practices. Don t wade through lengthy manuals and Web sites full of outdated information.
Move from reactive deals to shared costs and sustainable physician-hospital alignment. This edition provides fully updated strategies, tools, and step-by-step approaches from multiple ED call panel experts.
Peer Review Best Practices: Case Studies and Lessons Learned will help you transform peer review theory into best practice. This book and CD-ROM set is built on contemporary peer review design and demonstrates how hospitals have used those theories to tackle real peer review challenges. Twenty case studies cover topics ranging from fixing your peer review system to tracking and trending data to reconciling peer review conflicts.
David Clay Griffin, RPh, has over 30 years of experience in Retail and Community Pharmacies and still actively working as a pharmacist and pharmacy manager. Well-versed in practice standards and pharmacy operations, including controlled substance laws and policies, as well as financials, inventory, sales. Throughout his Pharmacy Management career, Mr. Griffin also served as a pharmacist for the United States Department of Health and Human Services in Dallas, Texas (2002/2017). He worked with the Texas 4 Disaster Medical Assistance Team and was the Pharmacy Unit Leader with NDMS over several missions. Mr. Griffin consults and serves as a pharmacy expert witness for attorneys representing both plaintiff and defense. His services include medical record review, thorough reports, depositions, and trial testimony. Areas of Expertise:
Mark A. Smith, MD, MBA, FACS, FACHE, CPHQ, is an independent senior Healthcare Consultant and a Practicing Vascular Surgeon as a Clinical Assistant Professor of Surgery at the University of California, Irvine.
Dr. Smith previously served as the Chief Medical Officer with Morrisey Associates Inc/ Morcare LLC for six years. He is a member of HG Healthcare Consultants LLC. Dr. Smith brings over 30 years of clinical practice and hospital management experiences to his work with physicians and hospitals across the United States. He is Board Certified in Vascular Surgery and is a Fellow of the American College of Surgeons, the American College of Healthcare Executives. He is a member of the American College of Physician Executives, the Society for Vascular Surgery and the Southern California Vascular Surgical Society.
Litigation Support - Dr. Smith provides expert witness services to attorneys representing plaintiff and defendant. His decades of clinical practice as a surgeon and multiple roles in senior hospital administration to his work on peer review, credentialing, ED call, and other matters involving physicians and hospitals across the United States. He has testified several times in the past 5 years.
Expert Witness: Retained in Washington, D.C., and over 25 states as an expert in hospital administration who could render opinion after assessing medical records, hospital policies and procedures, medical staff bylaws and regulations, JCAHO standards, depositions, etc. Served as Expert Witness for Plaintiff and Defense.
Consultant: Has assisted hospitals and health systems with accelerating their performance improvement efforts. Speaks, writes and consults on ethical issues in health care.
Consultant, Executive Vice President and Chief Operating Officer of the health system.
Executive Director of two academic medical centers: Emory University Hospital in Atlanta, Georgia, Stanford University Hospital and Clinics at Stanford.
Past chairman of the national advisory board for the University of Chicago’s Center for Clinical Medical Ethics.
An author of over 175 publications, he has written articles for USA Today, Health Management Quarterly, Trustee, Health Progress, the Journal of Health Administration Education, Frontiers of Health Services Management, Bioethics Forum, Modern Healthcare, the Cambridge Quarterly of Healthcare Ethics, Stanford Medicine, and Healthcare Executive among others.
Co-editor of Management Mistakes in Healthcare: Identification, Correction, and Prevention, published by Cambridge University Press in 2005.
Co-editor of Managing Ethically: An Executive's Guide, published by Health Administration Press in 2001, and a second edition, Managing Healthcare Ethically: An Executive's Guide was published in 2010.
Fellow of the American College of Healthcare Executives, a past member of its Leadership Advisory Committee, and a consultant on health care management ethics since 1994.
Served as a Distinguished Visiting Scholar at Stanford University’s Center for Biomedical Ethics.
Recipient of American Hospital Association's Award of Honor in 2009 and an Albert Schweitzer Leadership Award in 2012.
Faculty appointments held at Harvard, UCLA, Stanford, Emory, the University of California, and Seton Hall University.
Bachelor of Science, Master of Public Health, and Doctor of Public Health degrees are from the University of California, Berkeley.
Although there are still too many instances when clinical mistakes are denied, timely disclosures and apologies are not made, results of investigations are not shared and compensation offers are not extended, more hospitals are taking a less adversarial position.
In 1989, I agreed for the first time to serve as an expert witness in a case brought by the family of a terminally ill pregnant patient who had a cesarean section performed against her will in a prominent university teaching hospital. Since then, whether retained as a plaintiff or defense expert, I have been surprised and disturbed by the number and types of cases in which hospitals and other health care facilities have been sued.
The belated but formal acknowledgement of medical errors and their impact has been well documented.1 Curiously, the topic of management or executive mistakes in healthcare is not raised in professional meetings nor, until recently, addressed by an article in health administration journals
Ethical dilemmas are common in healthcare management. Although there is no handbook providing absolute solutions to ethics challenges, healthcare leaders can seek guidance and insight from others who have tackled similar issues. This book provides advice and inspiration from healthcare executives, ethicists, scholars, educators, and consultants. This collection of ethics columns from Healthcare Executive magazine will guide healthcare managers and executives in making personal and organizational decisions.
Raymond P. Mooney, PAC, DFAAPA, is a Physician Assistant with 46 years of experience in Family Practice, Emergency Medicine, Urgent Care, and Correctional Medicine as well as over twenty years of experience in reviewing medico-legal cases. He has extensive experience in deposition as well as trial testimony in state as well as federal court.
Background Experience: He has spent all his professional career after graduating from the University of Detroit Mercy, practicing in Michigan and is Board Certified by the National Commission on the Certification of Physician Assistants and a Distinguished Fellow in the American Academy of Physician Assistants. This distinction is awarded to physician assistants who have demonstrated outstanding dedication to the physician assistant profession. He is a member of the American College of Correctional Physicians, which complements and promotes his interest in correctional healthcare. For the past twenty-three years, he has been providing medical-legal reviews in family practice, urgent care medicine, emergency medicine as well as correctional healthcare. He has offered deposition testimony in approximately twenty-six states and trial testimony in state as well as federal court. Please feel free to review some of the articles that he has on his web site to assist attorneys in familiarizing themselves with the PA profession and other areas.
Mr. Mooney is also employed part-time as an independent contractor to staff the Emergency Room / Urgent Care Clinic at Dwane Waters Hospital of the Southern Michigan Prison. He is responsible for the evaluation and management of prisoners presenting for emergent as well as minor illnesses including trauma, cardiac events, respiratory distress, AIDS related illnesses, diabetes, etc. His duties also include the triage of calls from the remaining facilities in the Michigan prison system to determine the urgent nature of inmate complaints and appropriate disposition.
Litigation Support: With a diverse background as a Physician Assistant, Mr. Mooney has been providing the legal industry with his expert opinion for over 20 years. He is available to objectively evaluate cases for alleged medical negligence or a deviation in the standard of care on physician assistant practice.
Initial Attorney Conferences (No Charge )
Review / Prepare Affidavits of Merit for Medical Negligence Claims
Suicide is a threat to all persons (inmates as well as staff) involved in corrections. The rates of inmate suicide are far higher than the national averages and even higher still for special populations such as juvenile and LGBTI inmates.
Many States outsource prison healthcare (general medical care, mental health, and dental) to corporations that supply these services. The corporation retained to provide healthcare services to inmates is responsible for hiring the staff to care for the inmate population, which can include physicians, Physician Assistants (PAs), advanced nurse practitioners, and staff nurses.
An affidavit in legal terms is a sworn statement that assures the merit of your claim. In a medical malpractice case it is produced, at the request of the attorney, after the expert provider (physician, physician assistant/nurse practitioner) has reviewed the medical records and believes that the standard of care was breached and it was a cause that contributed to the patients injuries