What’s wrong with laundry list privileging?
June 3, 2019
So much has changed since the American College of Surgeons recommended laundry list privileging in the 1950s. At that time, many physicians had not completed approved residency programs in specific specialty areas—many were general practitioners or physicians trained on the job after they completed medical school.
The costs and administrative problems associated with laundry list privileging grow as new procedures are added that require updates to laundry list privileges and accompanying predefined criteria. Because laundry list privileges are updated so infrequently, additional risk-associated issues may also result.
Several difficulties with laundry list privileging are pointed out in the Greeley white paper (2015), Taking the Fear and Confusion Out of Core Privileges. These difficulties include:
- Maintaining and updating laundry lists as required when new procedures are identified.
- Keeping in mind that a laundry list is a representative sample of physician practice areas and not an exhaustive list.
- Responding to legal issues, particularly negligent credentialing suits, alleging a physician lacked the competence needed to perform a privilege: Often such privileges are one of dozens on a form. What if a physician performs a procedure that he is not privileged for on the laundry list? Does this count as negligence? What constitutes competence for each privilege on the laundry list? How does one avoid conflict and bias?
The bottom line is this: Laundry list privileging is no longer viable in terms of the costs, administrative difficulties, risk of negligent credentialing, and meeting regulatory compliance requirements including FPPE/OPPE.
Source: News & Analysis