What is the approval requirement to offer medical staff privileges to an applicant?
Medical staff privileges must be created, pre-approved and supportable by your facility to be offered to a privileged applicant. Often the "new privilege" is brought to the attention of physician leaders (credentials committee and/or medical executive committee) when an applicant asks for a new (and/or special request) privilege. The governing board has the ultimate authority and responsibility to parameter clinical privileges to match the facility support capabilities.
For example: Let’s say an orthopedic surgeon applies for general orthopedic surgery privileges and writes in the special request privilege of total joint replacement. Your facility does not offer total joint replacement surgery, as support services (e.g., in-facility physical therapy or equipment [operative and patient care] or nursing expertise) are not in place. The facility can simply ask the applicant to withdraw the special request as the facility does not offer the privilege for the reasons above. Such withdrawal of a privilege request does not trigger reporting to the National Practitioner Data Bank (NPDB). Any concern by physician or administrative leaders on NPDB notification potential should be discussed with counsel familiar with the legislation.