Does your hospital explain to your Professional Staff members the rules about taking a leave of absence?

Remember: Professional Staff members may include doctors, dentists, midwives and independent contractor nurse practitioners.

Since members of the Professional Staff are usually independent contractors and not employees of a hospital, they independently arrange for their colleagues to cover routine absences such as vacation and sick days. But how are longer term absences requested and approved? What are the rules?

More and more hospitals include a reference in their by-laws to a process whereby Professional Staff can request a leave of absence for extended time away relating to medical issues or disability; parental leave; and academic sabbaticals.

The OHA-OMA Hospital Prototype Board-Appointed Professional Staff  By-law includes sample language for hospitals to consider:

4.10 Leave of Absence

(1) Upon request of a member of the Professional Staff to the Chief of his or her Department, a leave of absence of up to twelve (12) months may be granted, after receiving the recommendation of the Medical Advisory Committee, by the Chief of Staff/Chair of the Medical Advisory Committee or delegate,

(a) in the event of extended illness or disability of the member, or

(b) in other circumstances acceptable to the Board, upon recommendation of the Chair of the Medical Advisory Committee or delegate.

(2) After returning from a leave of absence granted in accordance with subsection 4.10(1), the member of the Professional Staff may be required to produce a medical certificate of fitness from a physician acceptable to the Chief of Staff/Chair of the Medical Advisory Committee or delegate. The Chief of Staff/Chair of the Medical Advisory Committee or delegate may impose such conditions on the privileges granted to such member as appropriate.

(3) Following a leave of absence of longer than twelve (12) months, a member of the Professional Staff shall be required to make a new application for appointment to the Professional Staff in the manner and subject to the criteria set out in this By-law.

When writing policies to support the by-laws for Professional Staff leaves of absence, don’t forget to think about:

• How requests are to be made (including cases where a Professional Staff member has an urgent request related to an unexpected illness or short-notice adoption of a child or where a Professional Staff member cannot personally make the request due to injury or disability)
• Who has decision-making authority to grant a leave of absence
• The criteria to be considered when granting or refusing a leave of absence
• The individual’s duties prior to taking a leave of absence
• The individual’s permissions, obligations and restrictions while on leave (for example, are they allowed to visit while on leave? can they keep their hospital email address? are they allowed to exercise their clinical privileges? Are they allowed to complete outstanding charting? what will happen to their administrative duties?)
• How are leaves of absence reported to the regulatory body, insurer or indemnity provider
• How do individuals request to be reinstated and what evidence or information is needed to process a request to return to practice (if any)

On a practical basis, medical leaders also need to think about a communications strategy relating to a Professional Staff member’s leave.  What will be shared with patients? colleagues?  What does the Professional Staff member want shared and with whom?  What must be reported and why? Your  communication strategy should cover exits and returns.  Make sure the Professional Staff member leads the discussion about how much personal information will be shared and how to best support the Professional Staff member on their departure and return.