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Ask the expert: How should our hospital credential and privilege physicians for the outpatient section?

Hospitalist Leadership Connection, November 9, 2010

When physicians stop providing inpatient care (as delineated by inpatient privileges), hospitals must consider how and to what extent it will allow these practitioners to continue participating on the medical staff. Further, the hospital must determine how it will assess the competence of these providers.

Examples of the options hospital can choose from include the following:

• Allow the practitioner to remain on the medical staff without inpatient privileges
• Assign the practitioner to a special category of the medical staff (e.g., associate, courtesy, or honorary) with a diminished level of participation compared to inpatient physicians in the active category. The category must be consistent with the hospital’s bylaws and accreditation standards.
• Evaluate the practitioner’s competence in the outpatient setting
• Evaluate the practitioner’s competence via the hospitalist practice by evaluating prehospital care using a standardized evaluation form or setting a number of PCP chart reviews per year.

If a provider decides to return to active status, some institutions have found success implementing a mentorship or comanagement program for the transition period. The hospitalists may play a pivotal part before the provider can practice independently. If this option is pursued, the hospitalist program should work with the medical staff professionals responsible for credentialing and privileging and with the credentials committee to formulate the process.

Typically, the hospital’s medical staff bylaws must be modified to include the changes outlined above. Hospitalists’ input is beneficial at this level because they provide the majority of inpatient medical care in most institutions.

The above except is adapted from Hospitalist Case Studies: Tactics and Strategies for 10 Common Hurdles, published by HCPro, Inc.
 

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