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Rethink your AHP policy

Credentialing Resource Center Connection, May 28, 2003

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Dear Credentialing Colleague:

Let me tell you about a fair hearing that recently took place at a typical American hospital. This hearing lasted slightly over eight hours, involved five fair-hearing panel members, two lawyers, three witnesses for the appellant, and four witnesses for the medical executive committee (MEC). Also in attendance were one court reporter, one representative of management, and the appellant's employer.

The cost of this hearing, including all time spent, added up to nearly one-third of the appellant's annual salary. Fortunately, there was no appeal to the board of directors.

And just what action prompted this large expenditure of resources? The MEC had recommended the revocation of privileges previously granted to an orthopedic surgeon's casting tech. Yes, this non-licensed, non-certified casting tech had been granted clinical privileges.

Prior to the fair hearing, this tech acted without professionalism, courtesy, or dignity while in the hospital. After considerable investigation and deliberation, the MEC decided to revoke his privileges.

One might wonder why this individual was granted clinical privileges and given the right to a hearing in the first place. At the very most, his employer could have been granted permission to employ the casting tech's services pursuant to hospital policy. Revoking such permission would not, under any circumstances, give rise to a hearing.

The hospital's explanation for granting privileges to this allied health professional (AHP) was as follows:

"We were told by a JCAHO surveyor to grant privileges to all allied health professionals."

As most readers know, JCAHO standards do not require all AHPs to be privileged. The only AHPs to which the privileging mechanism applies are licensed independent practitioners who practice without supervision. The casting tech does not meet either criterion.

Review your policies and procedures to ensure that simple matters do not become overly complex at your institution.

That's all for this week.

All the best,

Hugh Greeley

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