Physician credentialing is the foundation of efforts to provide safe, quality clinical care within health care organizations (Joint Commission, 2007). Credentialing and privileging processes are established by those organizations to ensure that providers at all times possess the minimum required skills to function in specific roles. According to the Joint Commission (2007), a national accrediting agency for health care organizations, the credentialing process also should be able when needed to identify and remove from the medical staff any practitioner whose performance may threaten patient safety.
In addition to the interest in credentialing shown in Joint Commission accreditation standards, a majority of courts in the United States have recognized a hospital's duty "to investigate, select, and retain only qualified and competent physicians as members of its medical staff" (Watkins, 2005, p. 3). The failure to fulfill this duty has been identified as negligent credentialing, signifying the hospital's direct responsibility to a patient who is injured by an unqualified physician.
Specifically, the hospital is deemed responsible not for the physician's negligent acts, but for its own failure to conduct proper credentialing (Watkins, 2005).
In St. Luke's Episcopal Hospital v. Agbor (1997), Dr. Suzanne Rothchild delivered the Agbors' male infant at St. Luke's Episcopal Hospital in Houston. During birth, the infant suffered an injury that permanently disabled his left arm. The Agbors sued the physician for medical malpractice, and the hospital for negligent and grossly negligent credentialing. They alleged that the hospital had not followed its own credentialing processes by not revoking the physician's privileges after she had been the subject of several malpractice cases (Strama, 1997). The defendant filed a motion for summary judgment on the basis that, without a show of malice, the Texas Medical Practice Act (TMPA) provided immunity for decisions during the credentialing process. The district court...