Question of the Week

QUESTION:        We need some guidance regarding whether an applicant satisfies our threshold criteria for appointment and privileges.  Specifically, our criteria require that an applicant has not had his or her appointment or clinical privileges revoked at any other health care facility.

We have an applicant who checked “yes” on the application form with respect to whether his appointment and privileges have been revoked at any other facility.  He included a narrative explanation, stating that he disagreed with the other hospital’s decision to revoke his privileges and has instituted a lawsuit to challenge the hospital’s “unjustified and bad faith” action.  The applicant says he has obtained a preliminary injunction/ temporary restraining order preventing the hospital from “interfering with” his clinical privileges pending the outcome of the litigation.

Does the fact that the matter is being contested in litigation mean that the applicant satisfies our criteria until such time as the litigation is resolved?

Does the fact that the court has granted a preliminary injunction/TRO mean that the revocation is “on hold” – and, in turn, the applicant satisfies our criteria until such time as the litigation is resolved?

We really don’t want to get stuck in the middle of a contentious matter.

ANSWER:            Your situation is a real doozy!  As anyone who has been involved in a revocation of appointment and privileges knows – it’s a big, big deal.  Now that you are on notice of the other hospital’s decision to revoke this applicant’s privileges, it would not be prudent to throw caution to the wind and appoint the individual simply because he claims that the revocation was unfair and is in the process of being contested.  That would not satisfy your duty, as credentialers, to protect the patients of your healthcare community.

Since another hospital’s board has taken the action of revoking this individual’s clinical privileges, that individual fails to satisfy your threshold criteria.  You may be thinking, “But wait!  The applicant says the matter is contested.  And the courts have granted him an injunction.  Is it fair to apply the criteria to exclude this individual, given the circumstances?”

The answer to those concerns is:  What is fair and appropriate is what is best for patients.

In this case, another hospital has decided to revoke the physician’s appointment and privileges, thus rendering him ineligible.  The fact that the physician contests the matter is irrelevant to whether the physician satisfies your criteria.  If his challenge is successful, at that time, he will become eligible under your criteria.  And if his challenge is unsuccessful, then he will remain ineligible.  But, it is not within your power to resolve the matter and there is no reason you need to get in the middle of things.  Standing firm regarding this individual’s ineligibility is a good position to be in – and the right way to protect patients.