QUESTION:        There is a lot of confusion among our medical staff leaders about the relationship between medical staff appointment and clinical privileges.  For example, it is common to hear members refer to “Active Staff Privileges.” How can we help educate them on the distinction between medical staff membership and clinical privileges?

ANSWER:            Many medical staff members confuse or intertwine these two important concepts, even though they are entirely separate.  A lot of this confusion likely originates from the fact that many medical staff bylaws define staff categories by referring to the clinical practice of the individuals who fall within those categories.  For example, it is quite common for the “Active Staff” to be defined to include those individuals who conduct at least 24 patient contacts annually.

As such, it is important that your bylaws speak to membership and clinical privileges as distinct concepts.  Membership relates to an individual’s participation in the hospital’s or medical staff’s functions (e.g., committee membership, the conduct of peer review and other leadership functions, etc.).  The staff category that an individual requests – and is assigned to – relates largely to how involved the individual will be in such functions.  Those categories associated with more active involvement come with greater rights (such as voting and holding office).

On the other hand, clinical privileges relate solely to the individual’s provision of clinical services at the hospital. They do not relate to an individual’s involvement in hospital and medical staff affairs and, in turn, are not tied to the individual’s staff category.  Accordingly, an individual may be a member of the medical staff, but have no privileges.  Conversely, an individual may have privileges, but not be a member of the active staff or even the medical staff (e.g., telemedicine providers).

Ensuring your bylaws documents make this distinction is a good first step in educating your medical staff on this issue.