Health-care professionals, such as doctors, were appointed to the HSC's medical staff. As such they were not employees, but were professionals with a hospital appointment. They had hospital privileges, which meant that they were allowed to work in the hospital. As will be seen later in this report, professionals with a hospital appointment enjoyed a degree of autonomy that employees such as nurses did not enjoy.
Every member of the medical staff was appointed to a specific department. However, staff members could have more than one appointment. In such cases, the member had a primary appointment and a secondary appointment.
The medical staff was governed by the HSC's medical staff bylaws. (Exhibit 41) According to these bylaws, the medical staff were responsible:
To accomplish this, the medical staff was expected to maintain an effective system for making recommendations for the appointment, reappointment and the delineation of privileges. In addition, the bylaws stated that the medical staff should:
In short, the medical staff were responsible to the board for the "quality of patient care, education and research." (Section 4.1.11)
Members were appointed and reappointed to the medical staff on the basis of the recommendation of the Medical Advisory Committee. This committee made its decision based on applications submitted to it by the appropriate department head. According to the medical staff bylaw, Section 5.2.21,
In addition, the board, when deciding on an application, considered past performance in quality of patient care, ability to work with colleagues and staff, and contribution to administration and committee work.
Members of a department were responsible to the section head and the department head for meeting standards of patient care, performance of teaching and research duties, performance of administrative responsibilities, and appropriate attendance at meetings.
Each department was expected to have its own Department Council to act as a forum for communication and discussion between the department head and members of the department. As well, the Department Council could:
The Department Council comprised all members of the department (except for honourary and educational members) and persons who the council believed might be appropriately included in membership because of their association with the department.
Medical Staff Council
The Medical Staff Council was composed of the medical staff at the Centre and was intended to represent the interests of the medical staff. The council consisted of members of the active staff, members of the provisional staff and members of the scientific staff.
Medical Advisory Committee
The Medical Advisory Committee was the senior patient care committee responsible for advising the board on all matters concerning medical policy and issues.
According to the HSC bylaws, the main duties of the Medical Advisory Committee included:
The Medical Advisory Committee's membership included a Senior Vice-President, who acted as the chair. (Both before and after June 1, 1994 this position was occupied by Sutherland.) Other members included the President of the Medical Staff Council, three other officers of the Medical Staff Council, the department heads of the various medical departments and the Dean of the School of Medicine. The committee's non-voting members included the President of the HSC, the Senior VP of Operations, Senior VP of Nursing, Senior VP of Corporate Planning, the HSC Director of Research and the Director of Medical Administration. The Medical Advisory Committee met at least ten times a year.
HSC medical staff received their income in a variety of ways, besides the payment they might receive from the University of Manitoba for their academic duties. Department heads, section heads and subsection heads were paid by the HSC. In addition, they were entitled to bill the Manitoba government for medical services that they performed in the hospital. Surgeons, anaesthetists and other doctors similarly received a combination of direct payments and fee-for-service payments.
The members of the section of pediatric anaesthesia had established an arrangement with the hospital that introduced an element of income sharing to the manner of their remuneration. Essentially, members of the section performed their services and each was paid on the basis of the earnings received by the entire section (less an administrative fee).
|Current||Home - Table of Contents - Chapter 4 - Medical staff|
|Section 1||Chapter 1 - Introduction to the Issues|
|Chapter 2 - Pediatric Cardiac Issues|
|Chapter 3 - The Diagnosis of Pediatric Heart Defects and their Surgical Treatment|
|Chapter 4 - The Health Sciences Centre|
|Section 2||Chapter 5 - Pediatric Cardiac Surgery in Winnipeg 1950-1993|
|Chapter 6 - The Restart of Pediatric Cardiac Surgery in 1994
January 1, 1994 to May 17, 1994
|Chapter 7 - The Slowdown
May 17 to September 1994
|Chapter 8 - Events Leading to the Suspension of the Program
September 7, 1994 to December 23, 1994
|Chapter 9 - 1995 - The Aftermath of the Shutdown
January to March, 1995
|Section 3||Chapter 10 - Findings and Recommendations|
|Appendix 1 - Glossary of terms used in this report|
|Appendix 2 - Parties to the Proceedings and counsel|
|Appendix 3 - List of witnesses and dates of testimony|