Overview -

The term economic credentialing is an old phrase that carries different meanings for different people, especially physicians. Simply stated, it is typically defined as any medical staff credentialing decision that is based solely on economic or financial factors unrelated to a physician’s professional qualifications. To engage in economic credentialing has been seen as sacrilegious by most physicians, and such practices have been almost uniformly challenged by medical staff bylaws or any other medical staff rule, regulation, or policy.

Yet medical staff membership decisions based on economic factors vary widely among organizations, and some economic-based decisions have been in common use for many years. For example, exclusive contracts with hospital-based groups such as anesthesiologists, pathologists, and radiologists, which preclude physicians from applying for membership, have been the norm for at least two decades. Although they were challenged as anticompetitive and therefore a violation of state and federal antitrust laws, courts have universally upheld these agreements based on the argument that patient care is improved as a result of better continuity of treatment, 24/7 coverage, greater efficiencies, and other similar factors that are present when exclusive contracts are in place.

Originally published in Redesign the Medical Staff Model: A Guide to Collaborative Change in 2015.