Avoid denying an application whenever possible

There should be very few times when a medical staff needs to deny an application for privileges. For the most part, the physician and other LIP applicants are practitioners who have excellent records and will continue to deliver high quality in their ongoing patient care.

As for the few “problem children” who may apply, the organization should look for ways to avoid denying their applications. Doing so gives the applicant the right to a fair hearing. Fair hearings can result in a protracted quasi-legal process that can take a lot of time and money from the medical staff members and the institution. The typical bill for a fair hearing today averages about $500,000—and that is just the average for legal costs to the hospital and medical staff.

Most of this potential threat can be avoided by having (and following) robust policies and procedures, as well as sound institutional practices. Base all activities on the following premise: If an applicant does not meet the criteria set out in these policies, then the application cannot be processed. It’s important to understand that an application that can’t be processed is not the same as an application that is denied—an unprocessed application does not garner fair hearing rights. Let’s say an organization has a policy that no application is complete or can be processed until complete information is obtained regarding any untoward situation. Now let’s say that an applicant has applied for family medicine privileges and has requested obstetrics privileges to deliver babies. The institution has criteria stating that an applicant must have one year of experience in obstetrical care and must have delivered 30 infants in the past 12 months in order to get obstetrics privileges. If the applicant cannot provide proof of this training and recent activity, then the organization does not have to deny this practitioner; rather, the organization can simply opt not to process that particular request.

Source: The Credentials Committee Manual