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Temporary, disaster, locum tenens, and emergency privileges

Credentialing Resource Center Connection, June 4, 2009

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Anne Roberts, CPMSM, CPCS, is the director of medical affairs at Children's Medical Center of Dallas, where she oversees the medical administration, graduate medical education, and medical staff services departments.

Dear credentialing colleague:

As MSPs, we get many questions regarding the difference between temporary, disaster, locum, and emergency privileges. In order to better understand the differences between these different types of privileges, I think it is best to first understand that most organizations have clearly defined the difference between medical staff membership and clinical privileges. You can grant one without the other. This article will focus on privileges that do not necessarily require membership to the medical staff.

Each organization’s bylaws and policies and procedures should clearly outline the definitions of, and the credentialing requirements for, each of the different types of privileges. Below are sample definitions for time-limited privileges:

Temporary privileges may be granted to an initial applicant or current staff member for a limited period of time as defined in the medical staff policies and procedures. Temporary privileges may be granted when an initial applicant meets criteria as defined by the organization (including submission of a complete and red flag-free application), and they are awaiting approval from the medical executive committee or governing body. Temporary privileges may also be granted in order to provide services for an urgent patient care need, as long as the criteria outlined in the organization’s temporary privilege policy is met.

Disaster privileges may be granted to non-staff practitioners when the hospital incident command system (HICS) has been activated, if the criteria as outlined in the medical and dental staff policies and procedures are met. The disaster policy should indicate who may grant disaster privileges, under what circumstances, what the process is for granting and monitoring disaster privileges, and when the privileges expire.

Emergency privileges is a term used to identify a situation where a member of the medical and/ or dental staff provides treatment to a patient who is in extremis, as necessary to save life, limb, or organ, regardless of privileges granted. The care of the patient shall be turned over to a physician with appropriate privileges as soon as the emergency is under control.

Locum tenens privileges are given to practitioners who provide interim-staffing or temporary coverage for a current staff member when they are unavailable, such as when someone takes a temporary leave of absence or is out of town on vacation. Locum tenens physicians are typically not granted medical staff membership and are granted privileges only for a specific time-frame. Locum tenens services are typically coordinated through a locum tenens physician staffing agency. Larger organizations may not allow locum tenens services and may require coverage from current staff members with privileges— these services are optional and the organization’s policies should clearly define whether or not they will allow physicians to use locum tenens coverage. If so, outline the privileging criteria for locum tenens privileges.

Remember, clear, effective communication is the key to success!

That's all for this week.

All the best,

Anne Roberts, CPMSM, CPCS

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