Economic credentialing: are hospital privileges contingent upon skills--or economics?

Hospital medical staff privileges are granted to physicians who are able to provide quality patient care. Although there are no hard and fast rules as to what factors are considered when hospitals credential physicians, the perception and general practice has been that training, experience, and clinical competence are of primary importance. To foster aggressive peer review and credentialing practices in hospitals, federal and state laws provide protections for participants in peer review activities. Recent news in both legal and medical circles, however, is beginning to challenge that perception.