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Regents weigh new UI ‘downtown campus’ bylaws pending Mercy takeover
The new proposed bylaws 'contain modifications necessary to better align with the medical staff bylaws of UI Health Care’
Jan. 24, 2024 5:30 am
IOWA CITY — A week before Mercy Iowa City’s 150-year history comes to an end — with the bankrupt hospital expected to transition to University of Iowa ownership Jan. 31 — regents will meet Wednesday to consider new bylaws for the former Mercy campus, to be renamed UI Health Care Medical Center Downtown.
The proposed bylaws are based on Mercy Hospital’s original documents but “contain modifications necessary to better align with the medical staff bylaws of UI Health Care,” according to Board of Regents documents.
Given that the downtown campus will add to UIHC’s growing portfolio of clinics and centers statewide — including a new hospital in North Liberty and the main UIHC campus and Stead Family Children’s Hospital 2 miles west of Mercy — the bylaws aim to ensure “processes and information-sharing between medical staffs at each location are as consistent as reasonably possible.”
Although the documents don’t highlight differences between UIHC bylaws and those proposed for the downtown center, they do stress the university’s commitment to maintain an “open” medical staff at the downtown location and retain existing medical staff privileges.
Unlike UIHC’s closed staff model — requiring providers to be UIHC employees to practice there — Mercy historically has allowed practitioners from private clinics in specialties like OB-GYN, orthopedics and cardiology to hold medical privileges.
Earlier this month, the university reported making job offers to about 1,100 Mercy staff members — like nurses, receptionists and food service providers — and to about 53 physicians. Not all the offers were accepted, although specific numbers haven’t been made available.
Those former Mercy workers who do join UIHC will add to its 11,200-strong workforce — although the bylaws are different for the new downtown campus. “After the sale is complete, UI Health Care will operate two hospitals with two separate licenses,” according to the regent documents.
Staff classifications
Under the pending bylaws, UIHC downtown medical staff will be classified in one of five ways: active staff, associate staff, affiliate staff, consulting staff or honorary staff.
That is different from the five categories of clinical staff outlined in the UIHC bylaws, rules and regulations: active clinical staff, emeritus staff, courtesy teaching staff, temporary staff and house staff. Active clinical staff at UIHC either have a tenure-track, clinical-track, associate or fellow-associate or visiting faculty appointment.
Under the proposal for the downtown campus:
- Active staff must — among other things — have board certification, maintain an active office “within the geographic service area of the downtown campus,” be active in medical staff activities like committee and department assignments and agree to “personally fulfill all responsibilities in providing inpatient consultations, emergency room consultations, and inpatient attending coverage.”
- Associate staff are provisional, appointed for an initial term of two years, and can be appointed to active staff if board certified. If not, the provider is eligible for another three-year appointment “to obtain board certification.” Members of the associate staff also must maintain an active office within the downtown service area and treat patients at the downtown campus.
- Affiliate staff include practitioners who don’t attend to inpatients at the downtown campus but can refer patients there, visit them when they’re hospitalized and review their medical records. They can use the campus’ diagnostic facilities “without limitation” but can’t admit or treat patients at the campus or make medical record entries.
- Consulting staff include hospital-based specialists “not otherwise available on the medical staff, who are appointed for the specific purpose of providing on-site consultation in the diagnosis and treatment of patients.”
- And honorary staff include those who were active staff for at least five years and who’ve retired from active practice from the downtown campus “in good standing.”
The bylaws include a “credentialing policy” outlining the process for application, appointment and reappointment to the UIHC Medical Center Downtown medical staff. “No individual shall be entitled to appointment to the medical staff or to the exercise of particular clinical privileges in the downtown campus” only because he or she is licensed to practice and has a previous or current medical staff appointment or privileges at any hospital.
UI Health Care Medical Center Downtown also would “privilege advanced practice providers” — like physician assistants and advanced registered nurse practitioners — with a supervising physician maintaining “full responsibility for the actions of the APP.”
Advanced practice providers who “practice at UI Health Care Medical Center Downtown are permitted to practice only under the direct supervision of the physician that is designated as their supervising physician or is designated as their employing physician,” according to regent documents, which also says Mercy’s four named departments won’t change.
Departmental structure
Each department — medicine; surgery; maternal and child health care; family practice and emergency medicine — will be led by a department head, who'll serve for two years.
“The new bylaws do not alter this structure,” according to regent documents. But they do spell out a process for creating or dissolving departments.
“The Medical Executive Committee will periodically assess the downtown campus’ departmental structure and recommend to the Clinical Systems Committee whether any action is desirable for better organizational efficiency and improved patient care,” like, for example, “creating new or combining departments, eliminating departments.”
Comments: (319) 339-3158; vanessa.miller@thegazette.com
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