Don’t confuse medical staff membership with medical staff privileges

Editor’s Note: The following is an excerpt from The Credentials Committee Manual, written by Mark A. Smith, MD, MBA, FACS.

When the credentials committee considers an application, that application contains two parts. The first is for membership in the medical staff. Criteria for such membership may include type of licensure, education, training, and experience. The second part is for privileges, which define the scope of clinical care that an applicant can administer and should be matched to that applicant’s current clinical competency. There are certain criteria that applicants must meet in order to exercise particular privileges in the organization. These criteria may overlap with criteria for membership on the medical staff, but those for privileges tend to be more specific.

Can a practitioner be granted membership without privileges? Yes, absolutely. In fact, it happens all the time. Many medical staffs recognize emeritus staff—those who have retired but still maintain membership on the medical staff. However, since they do not practice any longer and do not deliver clinical care, there is no reason for them to have clinical privileges. If a practitioner does not have privileges, then there is no reason for the medical staff to evaluate his or her current clinical competency, which makes the reappointment process much easier.

Conversely, practitioners may have privileges but not membership. For example, most medical staffs do not grant membership to non-physician-level practitioners who are LIPs, such as PAs and NPs. Although they are not members of the medical staff, LIPs are granted privileges to render their scope of patient care. Another example would be a physician granted locum tenens (temporary) privileges due to an immediate patient need. If a patient required a neurosurgeon and there wasn’t one on staff, a neurosurgeon might be granted privileges to care for that particular patient, but he or she would not be granted membership to the medical staff.

The difference is that when practitioners are granted membership, they obtain political rights, such as the right to vote and to attend meetings. Privileges, on the other hand, define only what a particular person may do clinically within the organization.