• E-mail
• Print
• RSS

Establish parameters for physicians practicing in ambulatory care

Credentialing Resource Center Connection, March 24, 2005

Want to receive articles like this one in your inbox? Subscribe to Credentialing Resource Center Connection!

Dear credentialing colleague:

Credentialing processes must evolve to reflect the growing trend of family physicians and general internists who concentrate on office-based practice while admitting their acutely ill patients under the care of hospital colleagues.

Currently, many medical staff bylaws would not permit these physicians to remain on the active category of their hospital. However, physicians practicing in the community who refer their patients to hospital colleagues are certainly supporting the mission of the hospital and, in many instances, should be eligible for appointment to the active category of their medical staff. Bylaws provisions must be reevaluated by the credentials and executive committees and perhaps altered in light of these circumstances. This, however, is a political issue that must be discussed and resolved at the global level.

The issue of clinical privileges is slightly more complex. At some point, physicians practicing exclusively on an ambulatory basis will no longer be completely knowledgeable about current hospital procedures, pharmaceuticals, treatment modalities, and patient care practices. They will, in essence, not be able to demonstrate "current clinical competence" as is necessary for the granting of independent inpatient treatment privileges. As you adjust your policies and procedures in light of this reality, medical staffs might consider the following alternatives:

 Offering dependent clinical privileges that would authorize admission and full treatment of critically ill patients in conjunction with another fully qualified physician.

 Offering privileges that authorize referral and follow up with access to the patient record, test results, physician observations, and charts that may be considered by the treating physician.

 Defining and publicizing, in advance, the education, experience, or additional training that will be necessary in order for the practitioner to regain privileges authorizing treatment of acutely ill patients on an inpatient basis.

Above all, department chairs and credentials committees should recognize that family physicians and general internists who have chosen to restrict their practice to the ambulatory arena are highly qualified members of the medical community and should be welcomed members of the medical staff. Policies and procedures should be put in place to establish the parameters necessary for their continued inpatient privileges.

That's it for this week.

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

Want to receive articles like this one in your inbox? Subscribe to Credentialing Resource Center Connection!

• E-mail to a Colleague
• Print
• RSS
• Archive