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There is no right to MS membership

Credentialing Resource Center Connection, July 29, 2005

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Dear credentialing colleague:

Physician leaders should know by now that there is no right to either medical staff membership or clinical privileges. This is true even if a potential applicant is spectacularly qualified. Most hospitals are private corporations and have the ability to establish their own plans and policies on appointment or employment (consistent with applicable laws).

Consider the latitude that colleges and universities have in making staffing decisions. Simply because an application is received from a very well qualified professor does not obligate the university to even process the application, let alone approve it. First, the university would need to establish a need for a new professor. Then, it would have the opportunity to evaluate multiple candidates prior to making a selection decision.

Colleges and universities are very similar to hospitals. Both are often 501c3 organizations, nearly all are separately incorporated, most have a board of directors that is responsible for the operation of the organization, and both have highly educated staffs; colleges have faculty, hospitals have medical staffs.

However, colleges usually have a sufficient number of well qualified faculty, while hospitals often have either shortages or surpluses. Colleges also enjoy the near complete loyalty of their faculty, while hospitals often harbor their own competition among their medical staff. Furthermore, colleges have the ability to establish and enforce reasonable rules regarding study hall proctoring, while hospitals often have a difficult time establishing reasonable rules, let alone enforcing them, particularly in regard to emergency department coverage.

Regardless of their differences, both colleges and hospitals face substantial difficulties in terminating someone believed to be incompetent.

The major difference seems to be the presence of W2 forms for faculty, and this is precisely why so many hospitals are busy developing their own dedicated staff of employed physicians. Employment does have its advantages but like admission to college, it is a privilege, not a right.

That's it for this week.

All the best,
Hugh Greeley
http://www.greeley.com/seminars

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