Doctor Privileges and Hospital Accountability

When you go to the hospital and you are seen by a doctor, you will likely assume that the doctor is employed by that hospital. That is not always the case. Doctors tend to work like independent contractors, and are granted certain privileges to see patients within the facility. When that doctor commits an act of negligence or medical malpractice, part of our job as attorneys is to determine who, exactly, the doctor works for, and whether or not the hospital can be held accountable for your injuries or conditions.

In Maryland, you can bring a claim against a hospital for “negligent credentialing.” In short, negligent credentialing is the act of granting privileges to a healthcare practitioner who (for reasons such as incompetence, inexperience, misrepresentation, etc.) should not have had them in the first place.

Understanding how privileges work

Whether you were seen by a doctor at Johns Hopkins, Mercy Medical Center, or the UM Medical Center in Baltimore, or at any private or public hospital in Maryland, you are likely to have been seen by at least one doctor with privileges to see and treat patients there. They fall into three categories:

• Full. A doctor can admit patients to the hospital at any time, for any reason. Most doctors with full privileges will be required to attend at least some hospital meetings. There is no limit to how many patients they can admit.
• Courtesy. Under certain circumstances (depending on the practitioner and the case), a doctor can admit and then treat patients to the hospital. A doctor with courtesy privileges probably will not need to attend any meetings, but they are only allowed to work with a set number of patients.
• Surgical. This can fall under either category – full or courtesy – but it is granted only to surgeons.

Once a doctor or surgeon has been granted privileges, he or she must be evaluated (or “appraised,” as the medical community calls it) regularly to ensure that he or she is still worthy of those privileges. The Centers for Medicare and Medicaid Services mandates at least once every 24 months, but the UM Medical Center requires at least once every 9 months. Because there is no uniform system in place, it is entirely possible that you could be seen by a doctor whose credentials have not recently been reviewed, and whose privileges might be revoked – but after he or she treated you.

Furthermore, the rules governing reporting are not strict. According to the Maryland Board of Physicians website, for example “if a practitioner is denied specific privileges on initial appointments because he/she lacks experience in a particular medical procedure,” that information is not reported anywhere, leaving you with one less way to gather information about your doctor before choosing to see him or her initially.

It is important to know exactly who your doctor works for, and what level of accountability the hospital may have. If you or a loved one were the victim of medical malpractice, Plaxen Adler Muncy will work to hold all of the parties who are responsible for your loss accountable. Plaxen Adler Muncy, P.A. offers comprehensive counsel for victims of medical malpractice in Baltimore and throughout Maryland. To speak with an experienced attorney about your case, please contact us.