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Developing core privileges for emergency medicine

Credentialing Resource Center Connection, December 16, 2004

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Dear credentialing colleague:

Recently, I received several letters regarding the development of a core privilege delineation form for emergency medicine. How can you make sure that you have the best possible core privilege form for your emergency department (ED)? The answer can be pretty straight-forward, but turf battles can pose a challenge that hospitals must overcome.

Delineating core privileges in emergency medicine is actually a fairly easy process.  Usually, emergency medicine core privileges include the provision of urgent and emergent treatment to any patient in need of assistance in the emergency department.  This also includes the provision of emergency care to inpatients at the request of an attending physician or representative of the nursing service.

Due to the fact that bylaws generally confer "privileges to do anything necessary in an emergency" upon all physicians, a list of more specific ED privileges is redundant and unnecessary.

I often find that the issue of reimbursement clouds the development of ED privilege forms.  For example, occasionally radiologists become concerned if ED physicians are requesting privileges to interpret x-ray film.  The issue of "official interpretation" is a separate hospital policy issue and should be dealt with as such.  Certainly ED physicians must be able to review film and render a preliminary interpretation.  Issues such as this should be avoided, and medical staff leaders must not bow to pressures to sway their decisions in one direction or the other when creating needed privileges. No privilege system should compromise an ED physician's ability to do all that is necessary to effectively treat a patient.

That's it for this week.

All the best,
Hugh Greeley

Editor's note: See the HCPro publication "Core Privileges: A Practical Approach to Development and Implementation" at www.HCMarketplace.com for more information on this issue.

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