Clinical privilege myth: Clinical privileges are owned by physicians

It is always useful to examine and dispel common myths regarding clinical privileges. One of the most common is that clinical privileges are "owned by physicians." Physicians are granted privileges by the board upon recommendation by the medical staff. Many physicians have difficulty understanding why this is.  
 
The board is responsible for the quality of care at the healthcare organization. A rich and long history of legal case law establishes and confirms this responsibility. The board does not know a lot about the quality of medical care provided at the facility, so responsibility for this is assigned to the medical staff and management.
 
The management staff is assigned the specific responsibility of monitoring and improving the quality of care provided by privileged physicians at their facility. The medical staff establishes a process to handle its responsibilities, which include credentialing and privileging, and establishes policies and rules for that process. The task of collecting and summarizing information is delegated to management, generally through a trained and experienced medical staff support professional. The medical staff, through its medical executive committee, evaluates and recommends privilege requests to the board. The board reviews, grants, denies, or approves these recommendations.
 
The concept is that "good fences make good neighbors." The medical staff, management, and the board each have defined or delegated responsibilities as described. Physicians do not own privileges. Physicians are mutually accountable to each other for the quality of care they provide.

William K. Cors, M.D., MMM
Vice President Medical Staff Services
The Greeley Company