Plaintiffs are looking for as many deep pockets as possible in a malpractice action, and hospitals have the deepest. Tort reform efforts to place limitations or “caps” on compensatory and punitive damages have increased efforts to add hospitals as a defendant. Recent developments in credentialing include a new emphasis on pay for performance (“P4P”) and expected or required quality outcomes as determined by public and private payors; greater transparency to the general public via hospital rankings, published costs and outcomes, accreditation status and state profiling of physicians; and a required focus on evidenced-based guidelines and standards and the six Joint Commission competencies (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and systems-based practice) as well as ongoing and focused professional practice evaluation (“OPPE” and “FPPE”) as a basis of determining who is currently competent to exercise requested clinical privileges. These developments have resulted in an unprecedented focus on how hospitals credential and privilege physicians as well as the volume of information requested and generated as part of this ongoing analysis. Partner Michael Callahan’s presentation on negligent credentialing developments explores the following topics: 

  • What a plaintiff must establish in order to succeed in a negligent credentialing case 
  • Review of recent cases and their impact on a hospital’s duty to protect patients 
  • Overview and impact of the Joint Commission Medical Staff Standards on negligent credentialing arguments 
  • How to successfully defend against these actions 
  • The importance of establishing and uniformly applying credentialing criteria as well as documenting grounds for exceptions to minimize negligent credentialing claims 
  • What impact your state’s peer review confidentiality statute has on the hospital’s ability to defend against these lawsuits 
  • How to maximize your peer review protections as applied to physician profiling and P4P information

Click here to view the presentation materials.