Ask the expert: If a sponsoring physician loses privileges or resigns, do dependent APPs lose their employment?

They could, depending on how your bylaws are constructed. First, it’s important to understand the different types of advance practice professionals (APP). Some APPs, such as physicians’ assistants, are credentialed through the medical staff but can only practice under the supervision of a medical staff member who has clinical privileges. Other types of APPs, such as nurse practitioners, are credentialed through the medical staff and may or may not practice independently, depending on state regulations. Clinical assistants (CA) are scrub techs, registered nurses, physical therapists, and other lower level healthcare providers who are not credentialed through the medical staff process. Rather, they are processed through the HR process and practice under the supervision of a physician on staff. APPs can be employees of the hospital or of a physician on staff.

Regardless of how you refer to these types of practitioners or how they are employed, make sure your bylaws or related policies enable the hospital to automatically terminate all APPs who come to the hospital through a supervising physician if that physician loses privileges or resigns.

The following is some sample language to include in your bylaws:

The privileges and status of an APP or CA shall terminate immediately, without any hearing or appeal rights, in the event that the employment of the APP or CA with the hospital is terminated for any reason or if the employment, contract, or sponsorship of the APP or CA with a member of the medical staff  is terminated for any reason. 

This week’s question and answer are adapted from The Greeley Guide to Medical Staff Bylaws, Second Edition, by Joseph D. Cooper, MD, CMSL. Now at a discounted price!!