Sometimes, patients will need to be treated in the hospital. In order for a physician to treat a patient in the hospital he or she must be privileged in the hospital where he/she will treat the patient. When a physician has hospital privileges it means that he/she is permitted to work in a particular hospital. If a physician works at more than one hospital, he or she has been granted privileges at each hospital individually.
Privileges are granted when the physician applies and the application is approved by a hospital board of directors. The hospital’s approval process considers the physician’s education, continuing education, and ability to practice medicine (mental and physical), reputation, licensing, and many other factors. The physician must renew his/her periodically after the initial acceptance by submitting another application and proof of continuing medical education (CME). The renewal requirements vary from hospital to hospital.
There are various levels of privilege that hospitals may grant. The physician can also apply for different privilege levels. The names of the privilege levels may vary slightly by hospital but these are the two most common.
· Admitting, full, unrestricted, attending: this privilege level allows admission and treatment in the hospital.
· Consulting: this level allows a physician to see a patient in the hospital at the request of another physician who has full privileges. Usually a consulting level physician cannot perform surgery in that hospital without special approval from hospital officials.
Physicians in private practice do not get paid by the hospital. Basically there is a “business to business” relationship between the physician and the hospital; doctor A admits a patient into hospital Z and both bill the insurance or the patient for their portions of the medical care.
On the other hand some doctors are hospital staff and do not have a private practice outside of the hospital. Some examples of physicians that may be hospital employed are the emergency room doctors, pathologists, radiologists, anesthesiologists and a rather newly popularized specialty called the hospitalist.