St. Paul's Hospital is a busy teaching institution in the urban core of Vancouver, British Columbia. Although the standard of care is high, its Medical Advisory Committee (MAC), which assumes responsibility for monitoring the quality of hospital-based physician practice, occasionally becomes embroiled in issues of physician incompetence or impairment. In the absence of a clear and responsible process safeguarding both the privacy and integrity of the individual, on the one hand, and the need to maintain strict standards of care, on the other, concerns brought to the MAC may quickly escalate into legal battles between physicians and the hospital when more reasonable solutions should prevail. Following several incidents of this nature, the MAC charged a subcommittee to develop a policy that would balance the rights and responsibilities of the individual physician against those of the hospital, to try to pre-empt legal action. This policy would apply to all residents and staff.

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