Hospital Privileges should be open to all physicians with appropriate training and experience
Many physicians are committed to large groups even if they would prefer other arrangements for any of a number of reasons. (Examples: wish to work part-time, wish to spend more (or less) time with each patient, desire to hire ones own staff.) While many physicians on this source may be in large groups, I hope that all will consider your options if you wish to leave your group for any reason. This will allow you someday to partially retire, or to have a practice where you spend more time with patients, or have more staff, or see more Medicaid patients. You might make less money than acceptable in a large practice. Or, if you work really hard, you might be able to keep more of your income. When physicians leave a group, the large groups often block hospital privileges as the person has "no coverage", even if the physician is otherwise respected and had no problems while in the large group. I have seen this in multiple places and with multiple specialties. This is monopolistic and has become a serious problem given the mega-hospital systems currently in place. I have personally seen other physician have their privileges blocked for low quality care, even when the care is not necessarily poor quality (it might be a legitimate difference of opinion) or when some of the physicians in large groups do the same or worse. (These situations were in other specialties, so I might be incorrect). Physicians who are blocked should have the right to appeal to a national or regional board for review or they should have the right to admit patients to the hospitalist service with some limitations on their orders as mutually agreed by the hospital staff and physician. It is recommended that hospitals require hospitals to arrange in patient coverage for all physicians with appropriate training. The criteria should be national, with appropriate modifications for rural, regional, urban hospitals and for specialties such as primary care vs. specialty. Physicians with hospital privileges should be required to cover other physicians with similar specialties while the patient is in the hospital unless the hospital provides hospitalists. Hospitals should provide first level coverage for malpractice for physicians while they cover patients from other practices. (There might be a charge for this to the physician.) There should be provisions to allow fair workloads.
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