Hospital privileges for family physicians: rights, rationale, and resources

This review discusses the factors responsible for problems incurred by family physicians in the process of applying for hospital privileges. They include issues such as local unfamiliarity with family practice as a specialty, regional needs for primary care providers, reluctance to "make waves," and the breadth of privileges sought. Major areas of contention center on the utilization of obstetrical, surgical, and critical care facilities. If a request for privileges is denied, the applicant does, however, possess the right of due process. This right is substantiated in law and includes appeal procedures consisting of an enumeration of specific justifications for denial, adequate notice of a hearing, and the opportunity to be present, rebut the evidence, and present a defense. When dealing with such conflicts, the family physician will recognize the importance of training-content documentation, a willingness to demonstrate competence, and resources for professional assistance through both local and regional offices of the American Academy of Family Physicians.