By the book: How to obtain hospital privileges

November 22, 2021
Adding optometry to the list of hospital outpatient services and inpatient consults not only realizes the high level of contemporary, optometric medical eye care doctors of optometry provide, but also leverages’ communities primary eye care providers in a way that is mutually beneficial for patients, hospitals and doctors.
The privileges of providing care

Excerpted from page 43 of the September/October 2021 edition of AOA Focus.

Leveraging optometry’s prowess as America’s primary eye care providers is one of many reasons why the profession can—and is—making a difference in hospital systems the nation over. Although typically considered office-based, private practitioners, doctors of optometry holding hospital privileges ensure a continuity of care for patients by providing heightened awareness of the need for and value of in-hospital eye health care in the community, notes the AOA’s Optometric Hospital Privileges Manual.

The AOA’s Optometric Hospital Privileges Manual offers five recommendations for obtaining hospital privileges:

Suggested equipment for out-of-office exams
  • Direct and indirect ophthalmoscope
  • Condensing lenses
  • Handheld tonometer and autorefractor
  • Portable tangent screen
  • Foreign-body-removal kit
  • Cilia forceps and lid speculum
  • Distance and near acuity charts
  • Trial frames/lenses and Fresnel prisms
  • Refracting supplies
  • Pharmaceutical agents
  • Assessing the players. Find out which individuals or hospital committees are involved in this decision and gauge the reaction of your request for privileges. If resistance is likely, prepare to address concerns. Doctors may find it advantageous to have a sponsor help facilitate the process, e.g., hospital administrator or physician on the medical staff.
  • Making application. Hospitals may require a formal application form or letter indicating request for privileges (a template letter is available in the manual, Appendix A). Review the categories of providers within the hospital and request the highest appointment level when possible—the active staff level allows the broadest privilege and opportunity to serve on hospital committees. After category of staff, doctors should determine a list of clinical privileges or procedures they are requesting (Appendix B) as these will be reviewed by appropriate committees.
  • Credentialing. Required documentation may include proof of graduation, state licenses, diagnostic and therapeutic certification, malpractice insurance, completion of CE requirements, professional experience, up-to-date CV and more. Credentials will be reviewed at the time of request for staff membership, and a query of the National Practitioner Data Bank will be performed.
  • Privileging. Obtaining privileges may be a slow process, especially if applications from optometrists are new to the hospital or bylaws changes are necessary. Expect 3-6 months, generally, while a year or more is not out of the question. If denial seems inevitable, consider removing your application to better educate committee members.
  • Optometrist’s recourse if denied. Ask the hospital to provide reasons for denial in writing. Hospitals must follow their own rules—outlined in their bylaws—during the review process and this may be an opportunity to appeal if available.

AOA’s Optometric Hospital Privileges Manual

Find the complete AOA Optometric Hospital Privileges Manual for more information and tips on obtaining hospital priveledges and add the value of in-hospital eye health care in your community.


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The privileges of providing care

Adding optometry to the list of hospital outpatient services and inpatient consults not only realizes the high level of contemporary, optometric medical eye care doctors of optometry provide, but also leverages communities’ primary eye care providers in a way that is mutually beneficial for patients, hospitals and doctors.