Starting a medical practice: Getting Hospital Privileges

Many medical insurance companies will require MDs to hold hospital privileges to qualify to be part of their medical network.  If you want to do surgical procedures or round at the hospital, hospital privileges are needed. Obtaining hospital privileges are easy as of now. Hospitals needs MDs to send patients to their health care facilities. So most hospitals will be very helpful in helping you get privileges.

Understand the two parts of hospital privileges approval process: Credentialing and Privileges determination. Credentialing is that part of the application process in which it is  determined if the MD is qualified to get privileges.  The hospital medical staff office double checks on medical school, residency training, background check etc. The second step is giving privileges to do certain things in the hospital. For example the hospital may give broad privileges to do almost everything in your specialty including admitting patients, performing procedures pertaining to your specialty , consult and so on. Or the hospital may decide to give limited privileges, restricting the physicians to perform only certain medical procedures. or function. Certain hospitals may have exclusive association with a particular medical practice. And if you don’t belong to that exclusive medical practice, the hospital may allow you no privileges or some privileges. Yes! Welcome to the world of medical politics.

These are the steps to get hospital privileges:

STEP 1: Call the ‘medical staff office’ of the hospital and get a privilege application.

STEP 2: Fill and Submit it back to the medical staff office.

STEP 3: Follow up with your references to make sure they mailed the recommendations back to the hospital.

STEP 4: Make sure medical office has everything they need on your file, prior to the next credentialing committee meeting.

There are different types of hospital privileges. You may want to chose which is best suited for you:

Courtesy Privileges: Courtesy hospital privileges limit the physician to admitting only a nominal number of patients to the hospital. It still satisfies most medical insurance companies requirement for physicians to hold hospital privileges.  Physicians are usually exempt from attending medical staff meetings. Such privilege is used by physicians who do not expect to admit patients to the hospital or do procedures there.

Full Privileges: Under this category physicians are allowed to admit unlimited number of patients to the hospital. Physicians are usually given all the privileges needed to perform ‘core procedures’ of their medical specialty. Physicians are also required to attend a required number of medical staff meeting regularly.

The hospital privileges are renewed every few years. Currently it is done automatically, as long as physician’s morbidity or mortality rate is not too high as compared to their peers. But starting 2008, JCAHO is now requiring hospitals to develop criteria to renew hospital privileges every year based on measured criteria such as mortality rate, patient satisfaction score, complication rate, and, yes! believe it or not, even handwriting legibility. So holding on to the privileges will become quite a chore in the near future.