Low and No Volume
Practitioners:
Changing Practice Patterns Lead to New Credentialing Challenges
Audio CD/MP3
Recorded April 19,
2007
Faculty: Susan
Lapenta & Phil
Zarone

If your medical
staff is like most, you have a growing number of members who
have little or no clinical activity in your facility. Given
the hospitalist and other related movements (laborist, traumatist
etc.), many of these low/no volume
practitioners may not have clinical activity at any hospital,
centering their practices in their offices. Despite this shift
in practice patterns, many low/no volume practitioners continue
to apply for reappointment and clinical privileges.
How can your hospital
satisfy Joint Commission requirements for appointment and privileges
based on an assessment of core competencies when these practitioners
never admit or treat patients in your facility? How can you
perform the required ongoing and focused professional practice
evaluations for the low/no volume practitioner?
These questions
are made all the more difficult because many of these practitioners
have long been pillars of the medical community. Disenfranchising
them seems unreasonable and shortsighted. Is there a way to
allow them to continue to contribute to the hospital and medical
staff while still meeting Joint Commission and other requirements?
Susan Lapenta
and Phil Zarone, partners at Horty, Springer & Mattern,
discuss the low/no volume practitioner. Susan and Phil
offer practical solutions such as:
- What’s
in it for you?: The pros and cons of staying connected
with the low/no volume practitioner
- Establishing
threshold criteria for minimum patient contacts
- Defraying
the cost of recredentialing the low/no volume practitioner
- The
hunt for information – using reference evaluations
to get information about the core competencies of low/no
volume practitioners
- Obtaining
information from other health care facilities and managed
care organizations: Are state peer review protection
laws an obstacle?
- Staff
categories without clinical privileges – the wave
of the future or a thing of the past?
- Existing
criteria for appointment (including board certification,
no felony convictions and no exclusion from Medicare
and Medicaid) – should these apply to staff categories
with no clinical privileges?
- The
difference between Ambulatory Staff and Community Affiliate
Staff
- The
quid pro quo for appointment – satisfying service
call needs
- Credentialing
in an office setting - defining
criteria before undertaking the task
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