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Ask the expert: What's the downside to individually implementing core privileges?

Credentialing Resource Center Connection, August 2, 2007

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If a hospital chooses to implement core privileges on a physician-specific basis, some physicians in a given specialty will be practicing under core privileges while others will be practicing under another privileging mechanism. As a result, physicians' privileges may vary significantly between the two systems, opening the door for The Joint Commission to question whether the hospital provides a single standard of care, as required by standard MS.1.10, EP 4.

If your hospital employs such a system, it might need to prove to The Joint Commission that it provides a uniform standard of quality patient care, treatment, and services. Alternatively, it could try to prove two "equivalent" standards of care, despite the differences in physicians' privileges. However, hospitals should realize that a Joint Commission or CMS surveyor might challenge either assertion.

More information can be found in Core Privileges: A Practical Approach to Development and Implementation, Third Edition, by Carol Cairns, CPMSM, CPCS; Hugh P. Greeley; Beverly E. Pybus, CPMSM; and Richard A. Sheff, MD.

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