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Who has ultimate responsibility for decisions about medical staff membership, and why? How should this responsibility be performed?

The hospital board is the entity responsible for decisions about membership to a hospital's medical staff and the assurance of quality patient care within its facility. The board, through the credentialing process, ensures that providers wishing to join the medical staff are qualified and have the skills and experience necessary to provide high quality patient care. Additionally, the board has the duty of conferring facility specific privileges to medical staff members. These privileges, as outlined by the hospital board, authorize providers for specific patient care practices and are based on the credentialling process (Advantum Health, 2022).

Generally, these privileges fall into three categories: admitting privileges, courtesy privileges, and surgical privileges (Advantum Health, 2022). Admitting privileges authorize the provider to admit patients to a specific facility (Nabity, 2022). Courtesy privileges allow providers to occasionally admit patients to a specific facility and visit admitted patients regarding general medical care but don't necessarily authorize the provider to actively treat the patient within the facility (Nabity, 2022). Finally, surgical privileges authorize the provider to perform surgical procedures at a facility, as defined within their specific scope of practice (Nabity, 2022).

It's clear that responsibility for determination of medical staff membership resides solely with a hospital's board. However, this responsibility should be performed based on the recommendation of the existing medical staff (Showalter, 2020). For this reason, the board authorizes the medical staff to investigate applicant's backgrounds and any quality concerns involving active members of the medical staff (Showalter, 2020). Given that members of the hospital board may not be qualified to judge the professional competence of a physician applicant, it is imperative that the board consider the advice and recommendations of the medical staff when considering a physician applicant or conferring privileges (Showalter, 2020). For this reason, the hospital board generally approves the recommendations of its medical staff (Showalter, 2020). However, the ultimate decision-making responsibility for medical staff membership and conferment of physician privileges resides with the hospital board (Showalter, 2020).

Advantum Health. (2022).Applying for Hospital Privileges: What Physicians Need to Know.https://www.advantumhealth.com/applying-for-hospital-privileges/

Nabity, J. (2022, June 29).Hospital Credentialing: What to Expect as a Physician.https://physiciansthrive.com/hospital-credentialing/

Showalter, S. (2020)The Law of Healthcare Administration, Ninth Edition: 9. Health Administration Press. Kindle Edition.