Question:

How high can you set your threshold criteria for appointment? Clearly, a license to practice medicine in the state is required. Can you require an unrestricted license? Can you require that the physician’s license has never been restricted?

Answer:

As the practice of medicine becomes more complex, specialized, and hi-tech, many hospitals and their medical staffs have taken steps to strengthen the qualifications for medical staff membership and clinical privileges. Detailed objective criteria leave less room for subjective determinations that are more likely to be subject to legal challenges.

It is our experience that beyond even the most basic criteria such as completion of an accredited residency and maintenance of board certification, medical staffs have been implementing more stringent objective criteria, such as evidence of an “unrestricted” medical license that has never been suspended or revoked by any state agency; “unrestricted” professional liability insurance coverage; “unrestricted” DEA registration and state controlled substance license; no conviction of Medicare, Medicaid, or other federal or state governmental fraud or program abuse; no exclusion or preclusion from participation in Medicare, Medicaid or other federal or state governmental health care programs; no conviction of any felony or of any misdemeanor relevant to Professional Staff membership; and no adverse professional review action regarding appointment to the Medical Staff or clinical privileges by any health care facility for reasons related to clinical competence or professional conduct.

By incorporating these standards with the concept of eligibility, applicants who do not meet them are not “denied,” but, rather, are informed that they are not eligible to apply to the Medical Staff.To learn more about these and other credentialing standards that promote greatness, please join the attorneys of Horty, Springer & Mattern for their newest audio conference series entitled “Grand Rounds: Information Doctors Can’t Afford to Miss.” These 1-hour presentations will be held on the first Tuesday of every month and are designed with even the busiest physician’s schedule in mind. And, best of all, each live audio conference includes 1 CME credit! Click here to learn how you can participate and how you can save when you purchase the 12 conference series. The first audio conference, Cream of the Crop: Credentialing Standards That Promote Greatness, will be held January 3.