AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 718
(A-05)
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Introduced by:
Thomas Shieh, MD, Delegate, Guam
Subject:
Guam Memorial Hospital Medical Staff Autonomy and Physician
Independence
Referred to:
Reference Committee G
(Virginia T. Latham, MD, Chair)
Whereas, Our American Medical Association strongly supports any hospital medical staff whose
rights of self-governance are being threatened by the hospital administration or the governing
body; and
Whereas, Our AMA provides guidance on addressing hospital administration or the governing
body interference with medical staff self-governance and urges the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO) to aggressively enforce its leadership and
medical staff standards; and
Whereas, Our AMA has requested that the Litigation Center consider providing assistance in
appropriate cases regarding the protection of self-governance; and
Whereas, Guam Memorial Hospital medical staff have experienced difficulty in being recognized
as a self-governance organization, specifically when the medical staff voted to amend a bylaw
change which was denied by the Board of Trustees; and
Whereas, Guam Memorial Hospital medical staff members have been coerced, and forced to
take hospital “house call” against their will, and when the medical staff members requested that
the hospital relieve them of their call, they were threatened with the removal of their clinical
privileges; and
Whereas, Guam Memorial Hospital has essentially taken the members of our medical staff
hostage with the unreasonable demand of providing house call coverage, and threatening
removal of their privileges at the only civilian hospital further threatens and restricts the private
physicians from practicing their trade; and
Whereas, The medical staff of the Guam Memorial Hospital have requested the hospital
administration and Board of Trustees for mutual respect in developing a trusting relationship
and allow the process of making “house call” voluntary; therefore be it
RESOLVED, That our American Medical Association urge individual physicians or physician
groups that believe they are being coerced into specific employment arrangements to contact
the AMA/State Medical Society Litigation Center, their state medical association, and/or legal
counsel (Reaffirm HOD Policy); and be it further
Resolution: 718 (A-05)
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RESOLVED, That our AMA policy be that (1) the medical staff bylaws, rules and regulations
should be initiated and adopted by the medical staff and should establish a framework of selfgovernment; (2) the medical staff should govern itself by these bylaws, rules and regulations
which should: (a) be approved by the governing body, whose approval should not be
unreasonably withheld; (b) be reviewed and revised as necessary to reflect current medical staff
practices, and (c) define the Executive Committee of the medical staff, whose members are
selected in accordance with criteria and standards established by the medical staff; and (3) the
medical staff should have authority to approve or disapprove all amendments to medical staff
bylaws, rules and regulations (Reaffirm HOD Policy); and be it further
RESOLVED, That our AMA assist the Guam Memorial Hospital Medical Staff in a meaningful
discussion to maintain autonomy and the rights of self governance. (Directive to Take Action)
Fiscal Note: Staff cost estimated at less than $500 to implement.
Received: 5/10/05
RELEVANT AMA POLICY
H-225.989 AMA Opposes Forcing Medical Staffs to Repay Hill-Burton Obligations of Free
Medical Care
The AMA (1) opposes attempts to create new and arbitrary requirements for hospital
compliance with the Hill-Burton Act by shifting responsibility for these requirements to hospital
medical staffs; (2) believes that a hospital's Hill-Burton Act obligations should be satisfied in a
manner that does not interfere with the professional rights of its medical staff; and (3) endorses
exploration of means to assure equal access to medical care for the people of the U.S. (Res. 8,
I-79; Reaffirmed: Res. 99, I-84; Reaffirmed by CLRPD Rep. 3 - I-94; Reaffirmed: CLRPD 1, A04)
H-235.989 Medical Staff Bylaws
The AMA believes that (1) the medical staff bylaws, rules and regulations should be initiated
and adopted by the medical staff and should establish a framework of self-government; (2) the
medical staff should govern itself by these bylaws, rules and regulations which should: (a) be
approved by the governing body, whose approval should not be unreasonably withheld; (b) be
reviewed and revised as necessary to reflect current medical staff practices, and (c) define the
Executive Committee of the medical staff, whose members are selected in accordance with
criteria and standards established by the medical staff; and (3) the medical staff should have
authority to approve or disapprove all amendments to medical staff bylaws, rules and
regulations. (Res. 177, A-84; Reaffirmed: Sub. Res. 808, A-94; Reaffirmed by CLRPD Rep. 3 I-94; Reaffirmed: CLRPD 1, A-04)
H-160.927 Coerced Employment of Physicians
Our AMA urges individual physicians or physician groups that believe they are being coerced
into specific employment arrangements to contact the AMA/State Medical Society Litigation
Center, their state medical association, and/or legal counsel. (CMS Rep. 4, A-99)
See also:
H-235.990 Organized Self-Governing Medical Staff
H-235.974 Autonomy of the Hospital Medical Staff
H-235.980 Hospital Medical Staff Self-Governance
H-235.964 Preservation of Medical Staff Self-Governance
D-235.996 Preservation of Medical Staff Self-Governance