QUESTION:        During a recent on-site presentation, an attendee asked whether a hospital could impose requirements on physicians for medical staff appointment and clinical privileges that are more rigorous than the state requirements for licensing.

ANSWER:           The answer to this question is a resounding “yes.”  In fact, not only can a hospital do this, it most definitely should do this.  The requirements for licensing by a state board of medicine often establish a floor from which the hospital should begin in establishing its criteria for medical staff appointment and clinical privileges.  Medical staff policies should set the bar higher when it comes to threshold eligibility criteria so that you are only attracting, and granting medical staff membership to, highly qualified individuals.

For example, Florida law permits physicians who meet certain criteria to practice without medical malpractice coverage.  To be eligible for this exemption, some of the criteria a physician must meet include:

• The physician has held an active license to practice in Florida or another state or some combination thereof for more than 15 years.

• The physician maintains a part-time practice of no more than 1,000 patient contact hours per year.

• The physician had no more than two claims for medical malpractice resulting in an indemnity exceeding $25,000 within the previous five-year period.

Under the Florida law, the physician must also post a sign in his or her office reception area which provides as follows:  “Under Florida law, physicians are generally required to carry medical malpractice insurance or otherwise demonstrate financial responsibility to cover potential claims for medical malpractice.  However, certain part-time physicians who meet state requirements are exempt from the financial responsibility law.  YOUR DOCTOR MEETS THESE REQUIREMENTS AND HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE.  This notice is provided pursuant to Florida law.”

Even though the law permits part-time physicians to practice without medical malpractice insurance if the criteria are met, nothing prohibits the hospital from requiring a certain level of malpractice insurance for any physician who is appointed to the medical staff and provides clinical care to patients in the hospital.  Indeed, it would be imprudent not to require such coverage because it would expose the hospital to more risk and could result in a patient injured by proven negligence to not be compensated for his or her injuries.