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Ask the expert: I'm new to the medical staff services department. What is the difference between laundry list privileges and core privileges?

Medical Staff Leader Connection, September 16, 2009

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For many years, the standard method of privileging was referred to as “the laundry list.” Hospitals would provide applicants with lengthy documents featuring all of the procedures that practitioners in the same specialty or subspecialty were performing in the hospital. In some cases, applicants for privileges or medical staff membership would even get a list of the hundreds of procedures that all practitioners performed at the organization—not just those in the appropriate specialty or subspecialty. A practitioner applying for privileges would then check off the privileges he or she wished to perform.  Because the applicant was forced to select from a long list, hospitals rarely included any minimum criteria for each privilege, making it easy for physicians to request and obtain privileges for areas in which they had little or no experience.

Core privileges specifically define what training and competency is necessary for a physician to apply for and maintain a privilege. The term “core privileges” refers to those clinical activities within a specialty or subspecialty that any appropriately trained, actively practicing practitioner with good references would be competent to perform. Using the core privileging approach, practitioners who meet predefined criteria are eligible to apply for core privileges, and those who can document additional training and experience may request special or non-core privileges. Core privileging enables hospitals comply with The Joint Commission’s requirement for criteria-based privileges.

This week’s question and answer are adapted from Ready, Set, Credential, Second Edition by Nancy C. Lian, CPMSM, CPCS—now available at a reduced price!

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