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Reader question: Change in staff category

Medical Staff Leader Connection, September 9, 2004

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Dear Medical Staff Leader:

I recently received a question from a Medical Staff Leader Connection reader regarding a cardiothoracic surgeon who maintained a busy practice for many years. This physician completed a general surgery rotation as part of his training in the mid 1980s and was briefly double board certified. However, the practitioner allowed his general surgery board certification to lapse. He has been doing mostly thoracic surgery but he recently completed a fellowship with a busy general surgeon and is scheduled to take the general surgery board exam next month. The reader asked me to determine reasonable expectations for credentialing this surgeon and whether the facility should consider changing the practitioner's staff category.

This issue has very little to do with staff category assignment. It is primarily about privileges. Category assignment and privileges are two different issues. Category assignment is about voting and fulfilling medical staff responsibilitie. Privileging is about treating patients.

The credentials committee must determine the education, training, and experience a physician must have to qualify for clinical privileges. The committee must also determine whether the practitioner has competently performed the procedures (or a similar subset) an acceptable number of times. If not, the credentials committee can recommend the requested privileges are granted to the practitioner under the condition that he performs major procedures in conjunction with a qualified associate.

The reader's question does not provide enough information to determine whether the surgeon's past education and experience qualify him for general surgery privileges. However, what we do know about the practitioner indicates that he is qualified and committed to regaining skills that may have decayed while he devoted himself to thoracic surgery. The credentials committee should require the surgeon to demonstrate that he meets or exceeds the education, training, and experience criteria for the granting of the requested privileges. The committee must also gather references from the surgeon's peers that attest to his competence to perform the requested privileges.

That's all for this week.

All the best,

Hugh Greeley
http://www.greeley.com/seminars

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