What to do when the MEC and credentials committee disagree

Is it appropriate for the medical executive committee (MEC) to reject a credentials committee recommendation and forward its own recommendation to the governing board? Absolutely.

However, the board should be informed that the MEC's position is substantially at odds with the credentials committee's recommendation. The board should then investigate the divergent recommendations made by these two important committees.

It is also important to recognize that if the credentials committee's recommendation is supportive of a practitioner but the MEC's recommendation is adverse, the practitioner must be offered a hearing prior to formal action by the board. If the credentials committee's recommendation is adverse to the applicant but the MEC's recommendation is supportive, a hearing is not necessary under most medical staff bylaws.

It is recommended, however, that the MEC and the credentials committee chair meet in a joint conference whenever an MEC recommendation is contrary to that of the credentials committee. A joint conference should solicit the specific position supportive of both recommendations and tallow a direct sharing of information concerning the applicant or reapplicant. (It is not sufficient to have the applicable department chair represent the credentials committee's position). The credentials committee chair should be invited to participate in final MEC deliberations.