Episode 075: How Hospitals Work with David Leonard, JD

It isn't often that people walk into hospitals and ask themselves how does this thing work? In fact, the same can be said for those who work in hospitals too. Whether you're a doctor, nurse, phlebotomist, orderly, or patient - how the whole enterprise works is usually a mystery. Also, what protections are there for patients so that they don't have people who are grossly negligent or dangerous caring for them?

My guest today is David Leonard, Chief Legal Officer for the Spectrum System. Spectrum is a West Michigan based hospital system that currently comprises 15 hospitals, employed doctor group, clinics, laboratories, and health insurance plan (Priority Health). David has been with Spectrum since 2002 and has helped them navigate the merger and acquisition phases of their growth. Not only is the financial merger of hospitals and organizations difficult but trying to coordinate their governance and culture can be even harder.

It is the way hospitals run through a system of hospital boards and medical staff boards that makes their organization complicated and sometimes disjointed. It is a dance they have to do together to deliver the right care to the right patient with the right facilities and equipment.

We discuss the credentialing process which is a term used to describe the process of determining whether someone is fit to practice in the hospital. Along with that comes the disciplinary or corrective process to remove those who don't practice medicine well. That is best seen by the story of Dr. Christopher Duntsch from Texas. He was practicing in numerous hospitals in the Dallas area and none of them were willing to remove him until Herculean efforts were performed by some colleagues.