Hitting privilege potholes? Here's help
If you're seeking privileges your hospital has never given a family physician, you might want some help.
Kenneth Kline, M.D., had read electrocardiograms for 11 years in Ohio. He moved back home in 1996 to Glen Dale, W.Va., and sought privileges at a hospital where reading EKGs was the exclusive domain of internal medicine.
"No specific specialty 'owns' any procedure," said Kline. But he needed AAFP documents and his chapter's letters and phone calls to get his point across.
"The Academy and the West Virginia AFP added weight to my request to interpret EKGs," he said. "They showed it wasn't just my imagination that this procedure is really done by family doctors."
Kline was residency-trained in EKG interpretation, had taken recent courses on it and regularly read EKGs in his own office. However, the hospital's internal medicine department refused his request for privileges. "That's when I had to insist they follow the hospital's bylaws, stating that a request goes from a department to the credentialing committee to the board," said Kline.
The credentialing committee had no criterion except training as an internist. The committee eventually set criteria, Kline proved he met them, and the hospital board granted the privileges this February.
AAFP surveys indicate only about 4 percent of members consider their privileges "unduly restricted." Last year, about 680 members and others sought assistance or information from the AAFP on privilege issues. Among those calling the AAFP were 116 members with potential problems in seeking privileges and 21 members who had been denied privileges.
- AAFP helps by supplying materials such as:
- AAFP policy statements, following this principle -- "All physicians should be granted privileges commensurate with their documented training and/or experience, demonstrated abilities and current competence";
- a legal opinion on granting and denying privileges;
- a protocol on handling privilege problems, written for FPs who are medical staff members;
- guidelines chapters may use to help members obtain privileges; and
- procedural papers (see story on this page).
The Academy is also monitoring hospitals' adoption of subspecialist-oriented criteria recommended by the Credentialing Resource Center in Marblehead, Mass.
If you'd like assistance with a privileging problem, call the AAFP at (800) 274-2237, Ext. 3462.
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.