Make your bylaws inclusive

A lot of medical staff bylaws restrict board certification to American Board of Medical Specialties (ABMS) and its member boards—again, sometimes unintentionally. Doing so blocks physicians certified by osteopathic boards, non-U.S. boards, and any new boards created not under ABMS.

Elizabeth “Libby” Snelson, JD, Legal Counsel for the Medical Staff, PLLC, in St. Paul, Minnesota, advises medical staffs to look at their physicians to see who would be affected by tightening requirements for board certification. “If you set a standard for quality reasons and there is someone you have never had a quality issue with who would be axed, you are also denying patients access. What if it is your only pediatric pulmonologist and he or she happens to be ‘only’ trained in Canada? What are you really accomplishing?”

One way to ensure you are not losing quality physicians who are not board certified according to your bylaws is to include an equivalency clause. Snelson advises writing something like, “The doctor is board certified or standing for certification or otherwise establishes qualification for the privilege.”

Quality can be established through other means of credentialing already being performed, such as proctoring, peer review, or peer references.

Hospital medical staffs have leeway to include requirements about board certification in their bylaws and privileges delineation as long as they are doing it for quality, not discriminatory purposes, and they are following their bylaws. Snelson says most courts usually don’t want to get into the weeds of how hospitals ensure quality, but will find fault with a hospital that is not following its bylaws.

Source: Medical Staff Briefing