In the seminal decision Darling v. Charleston Community Memorial Hospital (1965), the Supreme Court of Illinois held for the first time in the United States that a hospital is legally responsible for making sure that a physician seeking appointment or reappointment to a medical staff is qualified to exercise each and every clinical privilege that is granted to him as determined through the hospital and medical staff’s credentialing and privileging procedures. If the hospital fails in its duty and knew, or should have known, that the physician is unqualified and the physician subsequently commits an act of negligence that injures a patient, the court opined, the hospital can be held separately liable for compensatory damages under what is commonly known as the doctrine of corporate negligence.

Since the decision was issued, approximately 40 states have adopted this liability standard. Sometimes referred to as “negligent hiring or selection” or “negligent retention,” this duty applies not only to hospitals but also to managed care entities, such as physician–hospital organizations and independent practice associations. Similarly, The Joint Commission, other hospital accrediting bodies, and state licensing boards impose clear and detailed obligations on hospitals and medical staffs to vet physicians’ qualifications at the time of appointment and reappointment and to continuously monitor their practices to ensure ongoing compliance with accepted standards of patient care services.

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