Position Statement

Delineation of Clinical Privileges in Orthopaedic Surgery

This Position Statement was developed as an educational tool based on the opinion of the authors. It is not a product of a systematic review. Readers are encouraged to consider the information presented and reach their own conclusions.

Orthopaedic surgery is the medical specialty that includes the preservation, investigation, and restoration of the form and function of the extremities, spine and associated structures by medical, surgical, and physical means. Orthopaedic surgeons who have successfully completed a residency program accredited by the Residency Review Committee for Orthopaedic Surgery have met educational requirements in the areas of diagnosis and care of disorders affecting the bones, joints, and soft tissues of the upper and lower extremities, including the hand and foot; the entire spine, specifically including intervertebral disks; and the bony pelvis. Further, orthopaedic education includes experience with all patient age groups, acute and chronic care, related clinical subjects including musculoskeletal imaging procedures, use and interpretation of clinical laboratory tests, use of prosthetics, orthotics, physical modalities and exercises, treatment of certain neurological and rheumatological disorders, and administration of local, regional, or spinal anesthesia.

Decisions regarding the granting of clinical privileges should be based upon a thorough consideration of each individual's qualifications rather than his or her identification with a specific profession. Each hospital medical staff should develop criteria for the delineation of clinical privileges which apply to all individuals who are permitted by law to provide patient care services independently. These criteria should serve as an objective framework from which to evaluate a practitioner's competence and should be clearly specified in the hospital's medical staff bylaws. At a minimum, these criteria should address licensure, training, experience, current competence, and health status.

Laws and regulations regarding the permitted scope of practice for physicians and other practitioners, and interpretations of these laws, are subject to frequent amendment and vary substantially among the states. Individuals involved in delineating staff privileges should review these laws periodically.

Several additional reference materials may prove useful to hospital staff members responsible for privilege delineation, for example:

• Accreditation Manual for Hospitals, Joint Commission on Accreditation of Healthcare Organizations
• Bylaws: A Guide for Hospital Medical Staffs, American Medical Association
• Delineation of Clinical Privileges: A Guide for Hospital Medical Staffs, American Medical Association

October 1989 American Association of Orthopaedic Surgeons.
Reviewed December 2007.

This material may not be modified without the express written permission of the American Association of Orthopaedic Surgeons.

Position Statement 1106

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