The American Academy of Family Physicians (AAFP) believes the full spectrum of family physician education and training supports a broad range of procedures and care settings, including ambulatory, in-patient, emergency, and critical care. For privileging purposes, the AAFP recommends family physicians document significant training and experience (e.g., procedural skills, deliveries, intensive/critical care, and treatment of major illnesses). Family physicians have the training, education, and experience to perform common medical, diagnostic, and surgical procedures (e.g., dermatologic, outpatient musculoskeletal, interpretation of electrocardiogram). Family physicians may have additional training and experience in specific care or procedures (e.g., colonoscopy, obstetrical deliveries). Where family physicians meet an institution’s privileging criteria for a procedure or service, they should be granted this privilege.
Privileging decisions and criteria should:
Non-physician clinicians are not the clinical equivalent of residency-trained, board-certified family physicians. Therefore, the AAFP opposes non-physician clinicians independently making privileging decisions regarding family physicians.
Emerging technology has allowed for new equipment (e.g., point-of-care ultrasound), procedures, and techniques to aid family physicians in the care of patients. Educational opportunities to learn new procedures and techniques should be available to all physicians, regardless of specialty. In the event of low or no volume experience, the hospital or health system should provide a method of determining competency that is consistent with Joint Commission standards. This competency assessment method must be applied equally and fairly to all medical staff so any physician applying for privileges, regardless of specialty, can prove competency.
All hospitals and ambulatory care settings should have a standing process for establishing the privileging criteria for a service or procedure new to that organization and for which no privileging criteria currently exist. The purpose for establishing this process is to assure that eligibility is determined fairly, and to rigorously ascertain competence, rather than promoting or limiting access to any specialty.
There are aspects of practice where family physicians face challenges in maintaining privileges that acknowledge the capabilities of full-scope family medicine. AAFP maintains the following policies on specific areas of importance:
(September 2022 BC)