QUESTION:   Our hospital is currently using a pre-application process for individuals interested in applying for clinical privileges and medical staff membership at the hospital. We also conduct interviews with these individuals, with the interview occurring before a decision is made on whether the individual satisfies the threshold eligibility criteria included in the pre-application. Is this acceptable?

ANSWER:    There are no legal prohibitions on conducting an interview with an individual who is interested in applying for medical staff appointment and clinical privileges before a determination is made about whether the individual satisfies the threshold eligibility criteria listed on a pre-application form. However, to reduce the chance of confusion about the reasons behind the interview, it would be best to make it clear to the individual that the interview is only being conducted in conjunction with the pre-application form and to make a determination about whether the individual satisfies threshold eligibility criteria. If the individual is deemed ineligible to apply because of information provided on the pre-application form and during the interview, there should be no reason for the individual to believe that he or she is entitled to a medical staff hearing or appeal under the Bylaws since there has not been a denial of the individual’s application.

A good way to achieve this clarity is by adding a paragraph to your pre-application form (or use a cover letter with the pre-application form) that informs the applicant that he or she is required to complete the enclosed pre-application form and that upon receipt of a complete pre-application and after an interview is conducted, a determination will be made as to whether the applicant is eligible to receive a full application for medical staff appointment and clinical privileges. You may also want to reinforce this process by spelling it out in the Medical Staff Bylaws or Credentials Policy.

Pre-application interviews can be tricky because they often, if not always, elicit a subjective response in the person conducting the interview. Nonetheless, we recommend that any interview that occurs before a decision is made on whether to extend an application form to an individual be conducted only to determine whether threshold eligibility criteria (i.e., information requested on the pre-application form) are satisfied.   If that decision is based on more subjective information, the greater the risk – especially if the individual is in a protected class because of race, gender, disability, age, etc.

If the decision is based on objective criteria only and the individual seeks a specific reason why he or she was deemed to be ineligible to apply for appointment, the reason will be much easier to articulate in any follow-up communication.