I've heard that your plastic surgeon should have hospital privileges... What does this mean, exactly? How do they get them and why do they matter for my surgery?
What Does It Mean for a Doctor to Have Hospital Privileges for a Procedure?
Doctor Answers 7
Hospital privileges in plastic surgery are vital to your research!
Good question! The point of asking for whether the doctor has hospital privileges is that if a pseudo (fake, sometimes called "cosmetic surgeon") plastic surgeon tries to get privileges from their hospital, their doctor peers in the department of surgery will evaluate them and decide if they have been properly trained to do this kind of surgery. If the hospital allows somebody to do surgery who really isn't qualified (but tries to advertise to you that they are) the hospital will be potentially liable in a lawsuit if complications occur. Consequently BEWARE of any doctor who wants to operate on you somewhere but doesn't have hospital privileges to do the same surgery in the hospital setting.
Dermatologists do not have hospital privileges to do liposuction.
Even though they may call themselves dermatologic surgeons. That is the gist of your question. Gynecologists do not have hospital privileges to do tummy tucks. And ENT surgeons do not have hospital privileges to do breast augmentations.
When you have office -based cosmetic surgery, you want to make absolutely sure that your surgeon can perform, in the hospital, the exact same procedure that will be done to you in the office. Hospital privileges are granted to a surgeon by a committee of other doctors who check the surgeon's credentials and training. And privileges then are approved by the chairman of the department.
So hospital privileges are an important assurance of safety.
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Plastic Surgery privileges
The act of granting a plastic surgeon hospital privileges to perform a specific procedure within our specialty is designed to insure that the operating surgeon has had the proper training and experience to procede with such a procedure. This decision is made by a plastic surgeon's peers who are familiar with such training and qualifications and is meant to protect patients from a physician who seeks to operate on someone without the background and training board-certified plastic surgeons possess. Outside the hospital environment (in a physician's office or clinic) these "privileges" are not necessary and the patient should rightfully ask their physician if they are certified by the American Board of Plastic Surgery.
Choosing a surgeon
Hospital privileges for a procedure means the hospital has reviewed the training and malpractice history of a doctor and will allow the doctor to perform the procedure in the hospital. The review is performed by a credentialing committee of other doctors on staff at the hospital. For example the hospital would never allow a brain surgeon to place breast implants in a patient. In the past this provided an extra layer of safety for patients in choosing a surgeon to perform a procedure.
An increase in office and outpatient surgery center numbers and performance of cosmetic procedures in these settings rather than hospitals has made this less clear.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
What Standards do Hospital Privileges Set for a Plastic Surgeon?
Every hospital has the right to set standards for the qualifications of its doctors. The majority of Seattle hospitals set very high standards for their physicians. "Privileges," or the right to perform certain procedures are only granted when a doctor has completed a post graduate residency in a specialty recognized by THE AMERICAN COUNCIL FOR GRADUATE MEDICAL EDUCATION. So an orthopedic surgeon would not have priveleges to deliver a baby and a neurosurgeon would not have priveleges to do cardiac surgery. The doctor must also be board certified in the same field in which they seek privleges by one of the boards recognized by THE AMERICAN BOARD OF MEDICAL SPECIALTIES. The doctor must have 150 hours of continuing medical education every three years, must be free of any criminal convictions, have no disabling medical conditions, no restrictions on the state medical license and have colleagues in the same field who will vouch for their competantcy. This is a minimum standard and it takes years to achieve. You should avoid any physician who cannot meet this standard.
The Important meaning of "Hospital Privileges" in Plastic Surgery to your wel-being
We live in a lawyers and lawsuit saturated society. According to the American Bar Association, there were 1,143,358 licensed lawyers in the US in 2007. According to recent statistics by the Bureau of Labor Statistics
we have 760,000 practicing lawyers in the US with law schools spilling an additional 45,000 graduates each year to an overly saturated market. It is not surprising that the result is than over 15 million lawsuits are filed every year - 16 million suits in 2002 (a new lawsuit every two seconds or a lawsuit for every 12 American adults) costing ALL of us a lot money. Americans spend more on lawsuits than any other country - twice as much as on new automobiles. The reason? While in European countries the loser in a suit must pay a large portion of the winner's legal fees, in America each party pays their own with many lawyers investing in and fronting some clients the cost of the lawsuit. With no penalties to those suing, in America there's nothing to lose by suing.
Since hospitals have a lot more money than individual doctors, plaintiff lawyers love to be able to drag hospitals into lawsuits because they stand to get much more money from them (either by winning the case or getting them to settle - a common form of economic extortion). For their parts, the hospitals want to increase patient safety and minimize the risk to their patients. They therefore scrutinize WHICH doctors are going to be allowed to practice in their facilities through a rigorous research process called CREDENTIALING. When completed and approved the hospital limits WHAT a surgeon can do based on his/her actual training. The list of operations a surgeon is allowed to perform in the hospital (PRIVILEGES) indicates that they were reviewed AND approved by the hospital.
A surgeon who does NOT have any hospital privileges in the operation he performs in his office and worse yet is not even allowed to admit patients to a respected local hospital should not be used. If the hospital will not take a chance allowing such a doctor to operate within its walls WHY would you allow yourself to be operated on by such an individual????
Please read the link below. It will explain the whole topic on WHO SHOULD BE PERFORMING PLASTIC SURGERY and the MEANING OF BOARD CERTIFICATION.
Peter A Aldea, MD
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.