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Clinical privilege myth #4: There are "textbook" criteria available for delineating clinical privileges

Medical Staff Leader Connection, February 20, 2008

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Because "textbook" criteria are not often available for delineating clinical privileges, the medical staff should establish policies and procedures to ensure an effective and consistent process. As part of the privileging process, the credentials committee must collect privileging criteria from as many sources as possible. These sources include:

• Postgraduate education programs
• Specialty board requirements
• Position statements from specialty societies
• National consensus where it exists
• Threshold volumes based on published research results, including literature linking physician volume with clinical outcomes
• Journals, articles, and literature search
• CME programs
• Device manufacturers where physicians serve as leaders or consultants
• Other hospitals or ambulatory sites
• Other physicians and credentialing specialists
• White papers from the Credentialing Resource Center (CRC) that summarize data related to threshold criteria for privileges.

Tip: When evaluating conflicting professional society positions on privileging criteria, recognize that these professional societies have conflicting missions. On one hand, an association may state its mission in terms of public interest or advocacy for patients with a particular spectrum of diseases. On the other hand, the same organization also serves the interests of physicians in the specialty it represents. These two missions are not always compatible.

Tip: National societies, boards, and other organizations overseeing the fields of interventional radiology, cardiology, and vascular surgery establish minimum threshold volumes of endovascular procedures irrespective of specialty.

Combined with strong policies to deal with new technology privileges and cross-specialty privileges, the effective medical staff should be well equipped to deal with clinical privileging challenges.

Stay well and be the best you can be.

William K. Cors, MD, MMM, CMSL
Vice President Medical Staff Services
The Greeley Company

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