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Not all physician employees of a hospital have hospital privileges, as they can be removed by order of the Chief of Medicine or the disciplinary board. Hospital privileges are usually specified for each physician employee, so that a surgeon would have the ability to book an operating room , but an internist would not. A physician does not have to be a hospital employee to get hospital privileges. For example, an independent surgeon may have the ability to book OR space for their patients.

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As another example, a family practice physician may get hospital privileges to visit their patients when they are in the hospital. In order to get privileges, most physicians have to have their credentials fully reviewed to determine if they are properly licensed and have the appropriate experience to perform the procedures they are planning to perform.


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The application form is shorter in that it is not necessary to obtain information regarding your training or associations prior to your current appointment. Again, there will be a release of information form and a privilege sheet.

All forms should be timely completed and returned to the MSO, along with the specified re-appointment fee. You should attach certificates from any training you received since you appointment or last re-appointment. Again, you should attach a copy of your current license, DEA and have your professional liability insurance carrier send a declaration sheet to the MSO. This time you will only need to have one peer send a letter to the MSO recommending your re-appointment.

Be sure to timely return your materials. If you do not allow the MSO adequate time to process your application, your appointment could expire and your privileges be temporarily suspended until it has been completed. In addition to the material you provide, the MSO will query the Quality Management Department to obtain information as to your performance in the hospital during the preceding 2 years.


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Checklist type evaluation sheets will be sent to the department chairmen of the other hospital where you are privileged. Once all of this information has been obtained, your section chief, if applicable, and department chairman will review all and complete a checklist evaluation form. Once approved, you will receive a letter confirming your re-appointment.

Hospital Credentialing and Privileging FAQs

If at any time you wish to perform an additional service or procedure, you should submit your request, in writing, to the MSO. You should attach the appropriate training certificates to corroborate that you are qualified to receive the new privilege. Your request will then be processed and forwarded to the section chief, if applicable, department chairman, Credentials Committee, Executive Committee of the Medical Staff and Board of Trustees. Once granted, you will receive a letter of confirmation. If between re-appointments your license, DEA, Board Certification or other certification renews, or you change your professional liability insurance carrier, be sure to provide the MSO with that information as soon as possible.

If you are disciplined by your regulatory Board or receive a formal notice of a medical malpractice claim Notice of Intent, Summons and Complaint , most facilities require the MSO be immediately notified. Should you plan to leave the area or for some other reason wish to resign your privileges, be sure to send a letter to the MSO, advising them of your intention and the date it will take place.

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You should provide them with a forwarding address. In addition to the credentialing function, the MSO serves as support personnel for the Medical Staff.

Hospital Privileges For Plastic Surgery

With your permission, they provide information about you to other hospitals, managed care companies and other entities to which you have submitted applications for privileges.