Medical Malpractice

The Doctor Is In: How Doctors Work with Hospitals

"So, where do you work?" It's a common question at cocktail parties and social gatherings. How do doctors answer that question? Do they work for themselves? Or for the clinics where they see patients? Or for the hospitals where they visit patients and perform surgeries? Often the answer is, "It depends."

Who's Working for Whom?

Many people assume the doctor taking care of them in the hospital is employed there, too. That's generally the exception rather than the rule. Any hospital can choose to employ doctors. But most doctors are independent contractors and instead have an arrangement with hospitals allowing them to see patients there.

Even emergency room (ER) doctors are generally not employed by the hospital where the ER is located. Instead, a separate business provides the ER physicians in shifts around the clock.

Why It's Important

When it comes to filing a lawsuit for negligent treatment or an accident against a doctor or hospital, your attorney will investigate who's employed where. This is important. The type and amount of insurance available to cover a lawsuit may be different for anyone you sue.

For example, if the lawyer claims the doctor's error was caused by not following the rules set by doctor's employer, then both the doctor and employer - like a hospital or clinic - will likely be sued.

Hospitals Grant "Privileges" to Doctors

Each hospital has its own set of rules, regulations and policies defining how doctors can admit patients, and how they're allowed to treat patients. Usually the rules require doctors to submit a written application for their privileges. The application contains extensive information about the doctor's education, license and experience.

Different categories of privileges exist. These include:

  • Admitting privileges - allow a doctor to admit a patient to the hospital
  • Courtesy privileges - allow a doctor to occasionally admit or to visit and treat patients in the hospital
  • Surgical privileges - to perform surgery in the hospital's operating room or outpatient surgery area

Often the decision of whether to grant privileges to a doctor is a group decision made by a hospital's credentialing committee. The committee thoroughly reviews the doctor's application and conducts an in-person interview, then votes on whether to accept the doctor.

Hospitals Can Impose Residency Requirements

Hospitals can have strict requirements that a doctor must follow before they're considered for privileges. These can include requirements that the doctor reside within a certain distance from the hospital to be sure that the doctor can arrive quickly when needed.

Timing Can Save or Cost Lives

Time can be critical, especially in the labor and delivery room. For example, a case in Illinois involved a doctor who took nearly an hour to arrive at the hospital for a complicated delivery, and during that time the infant died.

The evidence that may have swayed the jury to award pain and suffering damages to the mother was that the doctor showered at home before driving to the hospital. Also, while waiting for the doctor, the mother was aware the baby was dead while being delivered.

Whether the hospital has reasonable and strictly-followed rules about distance to the doctor's residence will be important to whether the hospital will be found legally responsible.

Work Together for a Better Stay

When talking to your doctor about a surgical procedure or hospital stay, you may wish to ask about the doctor's relationship with the hospital or group where the procedure will be performed. It may not be at the top of your list, but it could give you peace of mind and help you better understand the care you'll receive.

Questions for Your Attorney

  • Under what circumstances can I sue both the doctor and hospital? And when can I only sue the doctor?
  • I think I have a malpractice case due to surgery I had. Do patients have any responsibility to check out services provided by the hospital, such as anesthesiology before treatment?
  • Do parties such as hospitals or insurers have any duty to see that doctors affiliated with them aren't negligent?
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