Hospital Privileges

[stim4u]

Hello again:

As a Pain Medicine physician boarded through Anesthesiology, I am required to apply for hospital privileges via my primary specialty. Unfortunately, there are many private Anesthesia Departments not willing to allow competition into the market, inspite of offering non-comprehensive pain management services. Any ideas to combat the power of these Chief Medical officers on Medical Hospital Boards?

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[Aether2000]

There are two issues here:
Privileges are granted on the basis of training, so a fellowship in pain should qualify you for injections, RF, and dependent on your training, pumps and stims.
But exclusive contracts may prohibit you from delivering pain management services to the hospital if they are bundled in anesthesiology privileges. The only way around these are to 1. negotiate a subcontract with the anesthesiologists or 2. fight this legally. The former is preferred. However if there is only exclusive anesthesiology contract for anesthesia services that doesn't specify pain management, then you should be able to apply for privileges in pain management without the input of the anesthesiologists.

 

[stim4u]

Thanks Algosdoc...

Now I have even seen Anesthesia groups prevent Pain Medicine Anesthesiologist from getting privileges, but on the other hand allow PM&R physicians perform interventional pain procedures for their Orthopeadic collegues (with no comprehensive follow up, med management, and so forth). Not sure how ethical and legal this type of Old school negotiating is. I have spoken with several CEO's that do not have a clue and refer the issue back to their Anesthesia Chairman. In any case, I will push for the specifics and exclusivity of the contracts and request a denial in writting.

 

[Aether2000]

It may be wise to have a one on one chat with the anesthesiology chair rather than request a denial in writing unless you intend to pursue litigation. Many insurers and future hospitals will ask if you have ever been denied privileges at a prior hospital...a "yes" answer can open a can of worms....