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Commission approves revisions to SFGH medical staff bylaws to tighten temporary privileges
Summary
The Health Commission approved amendments to San Francisco General Hospital medical staff bylaws allowing limited email voting for routine credential business and tightening rules for granting temporary privileges; commissioners asked staff to restore CEO concurrence language and clarified that credentialing standards do not change.
The Health Commission approved several revisions to San Francisco General Hospital’s medical staff bylaws intended to tighten the temporary‑privileges process and speed routine credentialing.
Dr. Jim Marks presented three linked changes: (1) defining who may perform EMTALA medical screening exams (limited to physician members of the medical staff and authorized affiliated professionals, nurse practitioners, physician assistants and certified nurse midwives under a standardized procedure) to bring rules in line with a plan of correction to state survey findings; (2) permitting the credentials committee and the medical executive committee (MEC) to conduct email votes for routine business to accelerate approvals; and (3) narrowing circumstances under which temporary privileges are granted so they are used only for applicants with fully verified, 'clean' packets and only after credentials committee and MEC review when practicable.
Commissioners pressed staff on operational definitions. Commissioner Sanchez identified a deletion in section 5.2.2 that removed the CEO’s concurrence from a temporary‑privileges step; Dr. Marks agreed it was an error and said the language would be restored. Commissioners emphasized that the changes were intended to increase process rigor without lowering credentialing standards: "It doesn't change the credentials that are required," Dr. Marks said.
The commission moved to approve the bylaws as amended (to restore the CEO concurrence language) and the motion passed. There was no public comment on the item.
Why it matters: the changes are designed to reduce the large proportion of temporary privileges currently granted, improve oversight of credentialing decisions, and reduce administrative lag without changing substantive credential requirements.
What happens next: staff said they will correct the deleted CEO concurrence language in the final draft and proceed with implementation of the email‑vote process for routine credentialing business.
