CAFP's policy states that hospital privileges should be determined based on your training, experience, and demonstrated competence. In theory, your residency training and your track record of procedures and patient care should earn you the right to be proctored, to determine your current competence. In practice, however, it can be quite difficult to get the privileges to which you are entitled. Take a two-pronged approach, education and politics, if you are anticipating a struggle for privileges.
The California and American Academies of Family Physicians have a number of resources to assist you with privileges. These include:
- AAFP Protocol for Handling Privileging Problems, a step by step guide to the process.
- Family Practice in Health Care Organizations, a thorough examination of privileging.
- Family Physicians: The Logical Resource for Our Changing Health Care Environment, a meta-analysis of literature examining family physicians' quality of care.
- An AAFP-commissioned legal opinion about specialty-related privileging disputes.
CAFP will also write a letter of support outlining our policy. It can be addressed either to you or to the medical staff leadership, as you choose. To request a letter, contact Susan Hogeland
It's been said that all politics are local, and this holds especially true for privileging disputes. Hospital medical staffs are democratic, independent decision making groups and, the movement towards evidence-based guidelines notwithstanding, defining quality of care still happens one hospital community at a time.
An often overlooked component of privileging is the need for political engagement. Making sure that others are on your side is essential to your success. The first step is getting to know other physicians, both family physicians and specialists, on the medical staff. Building a solid relationship and understanding other peoples' issues and concerns is the key to being an effective politician. Your communications should be clear, respectful, and use a blend of inquiry and advocacy at all times. Use the information that you've gathered and stay calm and upbeat when pressing your case.