Write-in privilege requests

Some medical staffs include blank lines labeled “other” at the end of privilege request forms—but they shouldn’t. Including blank lines on privilege request forms encourages and invites applicants to add additional privileges that are not currently delineated on the forms and have not been recommended by the medical executive committee or approved by the governing board. One resultant problem is that a practitioner may write in a request for a privilege that is outside of the organization’s scope of services. Instead, applicants should be encouraged to practice within the approved scope of service described by the core for that specialty. The commonly requested privileges that are outside of that core—and that are appropriate to that discipline— should be identified on the delineation of privileges form, with preapproved criteria for each of those privileges.

If an individual applicant believes that he or she is adequately trained and competent in one or more privileges that are not covered by these two categories, then the burden should be placed on the applicant to identify the privilege in question and to provide evidence that he or she meets the criteria to be eligible for that privilege. Therefore, it is recommended that healthcare organizations delete any blank lines for additional privileges and the word “other” on the delineation of privilege forms. However, the medical staff should adopt a process for addressing privileges that are requested but are outside both the
core and the specifically-identified special (non-core privileges) for a particular discipline.