Hospitals May Require ‘Economic Credentials’

When hospitals want to expel a financially wayward doctor, they usually try to build a case of medical incompetence. But that may change.

Some experts contend hospitals have a right to begin “economic credentialing”-- basing doctors’ right to practice in the facility on their financial prowess as well as their medical skills.

“It’s a very controversial notion,” said John Blum of Loyola Law School in Chicago. “Physicians are not used to being judged on their economic performance rather than on their clinical performance.”

Blum recently surveyed 30 hospital administrators. Although none is using economic credentialing, he found many eager to have it written into their bylaws.

Writing in a health journal, John J. Eller and Sanford V. Teplitzky of the Baltimore law firm of Ober, Kaler, Grimes & Shriver made the case for using economic yardsticks to select new physicians and get rid of those on staff.

“Hospitals can and should consciously appoint the right mix of physicians who will be economic assets to the hospital instead of liabilities,” they wrote.

Among factors that could be taken into account, they said, are how long doctors keep people in the hospital, whether they use lots of hospital services for privately insured patients, how close their offices are to the hospital and even how old they are, since older doctors tend to cut back their use of the hospital as they near retirement.