How Are The Physician Privileges Determined?

All patients want good, skillful, qualified doctors. Naturally, hospitals want the same. That means that being a licensed physician is not enough to get hospital privileges. Hospital privileges can be called prescriptions that allow physicians to perform a certain set of operations and procedures, or even admit patients. As hospital executives say, without privileges, a physician can't be considered qualified.


There are several regulatory bodies - including Medicare, Department of Health and Senior Services, and Joint Commission on Accreditation of Healthcare Organizations- that hold healthcare facilities responsible for appropriately granting privileges to every physician before he can start practicing in the facility.


Getting hospital privileges is a complicated, tedious, and detailed process. But hospitals have to ensure patients get the best care. Physicians go through the similar process at all hospitals across the country, and each hospital is required to make an independent decision about the individual physician.


Before a physician, or any doctor, can treat patients in the facility, they have to fill out and submit the application asking for permission to practice at the hospital. They also have to obtain a permission to carry out certain procedures and treat patients at the hospital.


All of the physician's credentials - residences, education, training, experience, and fellowships - are carefully reviewed for appropriateness of competency and training. Most of the time, applications are verified by medical staff services and also reviewed by the leading physicians of the hospital.


Medical department's chairman and Credentials Committee set recommendations about special privileges and appointment to the staff. Then, their recommendations are reviewed by the Medical Executive Committee, and their results are sent to the Board of Trustees, which decide whether they approve the application or not.


If a physician meets all the guidelines and requirements, then he's granted privileges that he appear to be properly trained to carry out. Physicians can even obtain privileges to work in several hospitals, but the majority chooses to stay in one facility. However, privileges can be denied if the hospital decides a physician doesn't have a proper training or doesn't demonstrate competency. Besides, exclusion from Medicaid or Medicare, loss of medical license, or having found of abuse or frauds are reasons for withdrawal of hospital privileges. Privileges can also be suspended when a physician doesn't treat enough of patients to stay proficient or doesn't perform enough of procedures.


Physicians should state which specialty they want to practice, and all materials are sent to the chosen specialty. Then physician committee evaluates the application and makes the suggestion. However, the board decides whether or not grant privileges to the physician. If an employment contract allows, a physician can join more than one medical staff. Most often, a physician is needed at many hospitals when the specialty is narrow. It also helps to build the patient base and maintain professional skills.


Hospitals privileges are also required by many insurance companies that won't allow participating as a provider in the provider panels otherwise. For hospitals, it's also beneficial to grant privileges. It allows them to treat certain patients, improve medical equipment and generate revenue.


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