Notable revisions to the Guidebook include the fact that each of the following situations is now identified as a reportable change in a practitioner’s status:

  • “Acceptance of the surrender of clinical privileges or any restriction of such privileges… while under investigation.”
  • A leave of absence while under investigation that restricts privileges.
  • A reappointment review in which officials at the reappointing hospital have specific concerns about the practitioner’s competence based on the number or severity of medical malpractice cases.
  • A Quality Improvement Plan that:
    1. is the result of a provisional review action regarding competence or quality,
    2. restricts privileges, and
    3. remains in place after 30 days.
  • A requirement that a surgeon operates only with a qualified first assistant if the requirement is:
    1. imposed on a specific surgeon,
    2. a professional review action about competence and conduct, and
    3. in place after 30 days;
  • A restriction that is in effect for more than 30 days, regardless of the stated length of the restriction. (For example, a restriction on the surgeon’s next 5 bowel surgeries which ends up lasting more than 30 days.)
  • An adverse action that is the result of a private agreement between a provider and state agency.
  • An enforceable agreement signed by a board that an impaired practitioner will not practice, is in “inactive status,” or other voluntary agreement not to practice while under investigation or in exchange for not conducting an investigation.
  • Payment by a sole shareholder professional corporation relating to conduct by the shareholder physician or identified staff.

The October 2018 NPDB Guidebook is available at