Logan Reid
Hospital privileges are a critical part of a physician's ability to practice medicine and earn a livelihood. These privileges are authorizations that allow doctors to admit patients and practice at a specific hospital or facility. They are necessary for most physicians and can be revoked if the physician's conduct is deemed unprofessional or unethical, such as in the case of disruptive or abusive behavior towards colleagues or patients. Other reasons for the loss of hospital privileges include failing to maintain credentials or meet standards of practice, negligence, malpractice, or committing a crime.
| Characteristics | Values |
|---|---|
| Unprofessional behaviour towards colleagues or patients | Grounds for loss of privileges and potential termination |
| Quality of care | Documented issues pose a serious risk to the hospital and the doctor |
| Negligence or malpractice | Potential grounds for a lawsuit |
| Commission of a crime | Grounds for loss of privileges |
| Substance abuse | Grounds for loss of privileges and termination |
| Failure to maintain credentials or meet standards of practice | Grounds for loss of privileges |
| Professional competence or conduct | Grounds for revocation, termination, or restriction of privileges |
| Disruptive behaviour | Unethical and grounds for revocation |
| Failure to practice in a collegial manner | Grounds for revocation |
| Loss of privileges | Detrimental effect on a doctor's ability to obtain privileges elsewhere |
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What You'll Learn
Unprofessional behaviour
Hospital privileges are an important part of a physician's practice, authorising them to admit patients and practise at a specific hospital or facility. Unprofessional behaviour is one of the most common reasons for a doctor to lose these privileges. This can include behaving in an unruly or unprofessional manner towards colleagues or patients, which may also result in termination if the physician is employed by the hospital.
Unprofessional conduct can also include documented issues in the quality of care provided by the physician. This poses a serious risk to the hospital's reputation and liability coverage, and as such, may result in the loss or restriction of privileges. For example, a physician's application for surgical privileges may be denied if they are not board-certified in the clinical specialty and subspecialty for which they applied. Hospitals may also revoke privileges if a physician fails to meet the minimum number of procedures prescribed for a particular specialty.
In addition, unprofessional behaviour can include negligence or malpractice, which could potentially result in a lawsuit. Hospitals may also revoke privileges if a physician fails to maintain the required credentials or meet standards of practice, such as maintaining an active license, malpractice insurance, and timely completion of medical records.
Substance abuse is another form of unprofessional behaviour that can lead to the loss of hospital privileges. Doctors with substance use disorders pose a serious risk to themselves and others, and practicing medicine under the influence is grounds for termination of privileges.
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Poor quality of care
One aspect of providing quality care is adhering to accepted standards of practice. Physicians are expected to maintain an active license, malpractice insurance, and comply with established standards. This includes the timely completion of medical records and maintaining credentials required by the hospital. Failure to meet these standards can result in the loss of hospital privileges.
Another critical factor in ensuring quality care is practicing in a collegial manner. Physicians who exhibit abusive, disruptive, or unprofessional behaviour towards colleagues or patients are at risk of losing their hospital privileges. Such behaviour is considered unethical by the American Medical Association, and hospitals have a low tolerance for disruptive practitioners. This includes intimidating or threatening behaviour towards other medical staff, which can negatively impact the collaborative environment necessary for effective patient care.
Additionally, modern hospital practice often requires a team-based approach to treatment. Physicians who consistently fail to involve consulting physicians or specialists when necessary may face criticism for jeopardizing patient care. While the independent nature of physicians is valued, hospitals expect doctors to recognize when specific aspects of treatment would benefit from the expertise of other medical professionals. This collaborative approach enhances the quality of care provided to patients.
It is important to note that the loss of hospital privileges can significantly impact a physician's ability to practice medicine and earn a livelihood. Hospitals have broad discretion in controlling admission to their medical staff, and physicians may find it challenging to obtain staff privileges elsewhere after being removed from a hospital's medical staff. Therefore, maintaining a high standard of care and adhering to professional conduct is essential for physicians to uphold their hospital privileges and continue serving their patients effectively.
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Criminal activity
Physicians are expected to maintain certain standards of professional competence and conduct. Failure to do so can result in an investigation, which may lead to the reduction, restriction, suspension, or revocation of clinical privileges. Hospitals are required to report professional review actions that adversely affect a physician's clinical privileges for more than 30 days.
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Substance abuse
Hospital privileges are an important part of a physician's practice, authorizing them to admit patients and practice at a specific hospital or facility. However, substance abuse issues can be a significant factor in the loss of these privileges.
Hospitals typically include requirements related to substance abuse in their medical staff bylaws, which may also allow them to request treatment records of practitioners with a history of substance abuse. State medical boards, hospitals, and other healthcare organizations must comply with federal and state laws while considering a physician's substance abuse issues. They must balance patient safety and the physician's right to privacy and equal access under laws like the Americans with Disabilities Act (ADA).
While seeking treatment for substance abuse, physicians may face regulatory and workplace barriers due to concerns about confidentiality and the potential impact on their medical licenses and privileges. They may choose not to seek treatment due to these concerns, which contributes to the high rate of suicide among physicians.
To address these issues, hospitals and medical boards must strike a balance between patient safety and the well-being of physicians. This includes providing support and treatment options while also maintaining the standards of professional conduct and competence expected of medical professionals.
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Failure to maintain credentials
Hospital privileges are a critical part of a physician's ability to practice medicine and earn a livelihood. They authorize doctors to admit patients and practice at a specific hospital or facility. Admitting privileges, for example, allow a doctor to admit a patient to a hospital, while telemedicine privileges allow a doctor to provide care and treatment to a patient in a hospital via telemedicine.
Doctors are required to maintain an active license, malpractice insurance, and comply with certain generally accepted standards of practice. Failure to maintain credentials or meet standards of practice is a common reason for the loss of hospital privileges. For instance, a physician's behavior towards colleagues or patients becoming unruly or unprofessional is grounds for loss of hospital privileges and potential termination if the physician is employed by the hospital.
The American Medical Association considers disruptive behavior unethical. Physicians who are viewed as rigid, inflexible, and defiant are likely not practicing in a collegial manner and are at risk of becoming a target for a revocation of staff privileges. Courts have routinely upheld the decision of hospital boards to revoke staff privileges based on abusive, disruptive behavior.
Furthermore, maintaining a high level of care is paramount not just for the patient's health and well-being but also for the hospital's reputation and liability coverage. Documented issues in the quality of care can pose serious risks for both the hospital and the doctor, leading to the loss or restriction of privileges.
If a hospital initially recommends revoking, terminating, or restricting a doctor's clinical privileges, it is generally not a final decision. The physician in question typically has the right to a fair hearing and legal representation during the process.
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Frequently asked questions
Hospital privileges authorise doctors to admit patients and practice at a specific hospital or facility. Examples include admitting privileges, telemedicine privileges, and surgical privileges.
There are several reasons why a doctor may lose hospital privileges, including unprofessional behaviour, documented issues in quality of care, negligence or malpractice, failure to maintain credentials or meet standards of practice, and committing a crime.
Unprofessional behaviour can include being abusive, intimidating, or threatening to colleagues or patients. Physicians are expected to practice medicine as a team, and failing to do so by not consulting other physicians when necessary can be considered unprofessional.
If a hospital decides to revoke a doctor's privileges, the doctor will typically receive written notice of the decision along with an explanation. The doctor then has the right to a fair hearing on the decision and can be represented by legal counsel during the hearing.
Losing hospital privileges can have a significant impact on a doctor's ability to practice medicine and earn a livelihood. It may also make it more difficult for the doctor to obtain staff privileges at another hospital.
