From the article:

Existing within hospitals across the county is a delicate balance between the medical staff and the governing board. Threats to this balance surface periodically, often in the area of peer review. When such controversies arise, the carefully constructed balance of power that allows the hospital to function, while keeping the protection of patients paramount, finds itself in danger. Unfortunately, the question of how to integrate and unify the medical staff and the governing board in the peer review process is not an easy one to answer. Some blame the traditional model of a “self-governing” medical staff, contending that it is a source of “dysfunction and paralysis” that stifles the governing body’s ability to fulfill its ultimate responsibility for patient care at the hospital. However, whether one is a defender or detractor of the self-governance model, it should be acknowledged that both The Joint Commission (TJC) and Centers for Medicare & Medicaid Services (CMS) believe in preserving medical staff self-governance. Thus,for the time being at least, medical staffs and governing bodies need to focus on working together in a collaborative process. This article will suggest that medical staff bylaws incorporate a formal dispute resolution process as a useful tool for promoting such collaboration.