"Privileges" For Doctors At Hospitals

Greetings.

Please forgive my ignorance, but what does it take for a medical doctor to get “privileges” at a particular hospital? Do you just take your license down to Ye Olde Regional Medical Center and ask if you can play too? Do you pay a fee for the privileges? Sign a contract? Submit to a background check? Interviews? Or what? Is it a big pain in the neck or a pretty easy process? Once you have the privilege to work at a hospital, are you required to do so–-you know, be on call every so often for certain kinds of emergencies or otherwise serve the medical facility? I know from my monthly trips to the emergency room (I’m clumsy) that many of the specialists called to my hospital of choice at night work all day long at their respective practices.

I guess I just want to know how the whole thing works.

Thanks in advance for your answers and have a great day!

In college I dated a nursing student. She told me this joke:

A nurse dies and goes to Heaven, which is of course a huge hospital. She gets in a long line at the cafeteria with the other nurses. A guy in a white coat with a stethoscope around his neck walks past them to the head of the line and helps himself to lunch.

The newly arrived nurse says, “Those doctors and their privileges!”

Another nurse says, “Oh, that’s God. He just thinks He’s a doctor.”

It’s a pain. You apply to a particular hospital for, say privileges in the department of Family Practice. This generally lets you admit patients, & see them in the ER. You get to write orders that will be carried out. You may apply for additional privileges, such as doing sigmoidoscopies in the hospital’s GI lab, or delivering babies there. You provide tons of documentation regarding your license status, training, outstanding or settled lawsuits, previous hospital affiliations, willingness to take hospital call, etc. etc.

Then the hospital decides what privileges to grand. If you’re trained as a family doctor, but asked for privileges to do brain surgery, they’ll probably not grant them. But if your requests are in line with what a Family Practitioner can do, and your training reflects your ability to do this stuff, and you’ve got a free and clear license and are not in a bad odor with other hospitals, etc. etc. you’ll probably get privileges.

This also gets you on hospital committees, so you can take time out of patient care (where you earn all your money) to sit and wade thru paper and regulations and lawyerese and try to make decisions about any number of things. But that’s a whole 'nuther topic.

That’s it in a very simplified nutshell. There’s lots more to it, and key parts I’m sure I’ve overlooked, that others here can chime in on.

QtM, MD
(who currently has privileges only in state prisons, thank the gods!)

The credentialling process is a lot of fun. :wink:

The physician must submit proof of licensure, malpractice insurance, a curriculum vitae (resume), and in some cases, must also give a transcript from medical school. Some hospitals do require background checks and reference checks.

What hospital privileges do for the doctor is allow the doctor the use of their facilities, including performing surgery and other procedures; order tests; admit and discharge patients; and basically Be a Doctor.

The MD’s responsibility to the facility is to comply with hospital regulations, including the dictation and signing of medical records; working within the scope of licensure and hospital privileges (there are different levels of this, BTW); and being available for necessary consultations.

Applying for privileges isn’t mandatory; lots of doctors don’t. Their patients’ care is turned over to either a partner of the practice or to a hospitalist whose job it is to take care of patients while in hospital.

I’d imagine Qadgop and/or DoctorJ will be along shortly.

Robin

And oh yes, you have to sign all sorts of forms, and some hospitals have administrative fees, and some require interviews and some don’t, etc. etc. etc.