Ask the expert: How can we diffuse tensions among physicians when deciding to grant privileges across specialties?

Medical staffs should consider creating a multidisciplinary task force to deal with each specific instance of crossover privileges. The team should include specialists from each of the involved specialties, as well as any other people in the organization pertinent to the discussion, such as OR supervisors, nurse directors, or hospital administrators, says Terry Wilson, BS, CPMSM, CPCS, director of the medical staff services department at ­Flagler Hospital in St. Augustine, Fla. She recommends that the team addresses the following concerns:

• Which specialty should perform a procedure
• Whether the procedure should cross specialties
• Why it should cross specialties
• What competency levels are required for individual specialists to perform the procedure
• The financial feasibility of the procedure for the hospital
• Special equipment or training required to perform the procedure
• Where the procedure will be performed

After thoroughly researching and discussing the issue, the task force should make recommendations to the credentials committee, which considers it and in turn makes recommendations to the medical executive committee (MEC). The MEC also weighs in on the recommendations before the issue moves on to the board, where the final decision is made, according to Wilson.

"The best advice is to get all the right people involved up front to discuss it," says Wilson. "That way, you hide nothing, it's an open and frank discussion, it's fact-based, and you deal with it at that level first."

This week’s question and answer are from Medical Staff Briefings, HCPro, Inc.’s monthly newsletter that provides the strategies and updated information medical staff leaders and MSPs need to confidently meet their daily challenges.