Qualifications for Clinical Privileges
of Plastic Surgeons

As the health care system in this country continues to change and evolve, the lines that define the various area of medical speciality become more and more blurred. However, the training and skills that define medical specialists and surgical specialists remain distinctly different.

In the United States, physicians are generally licensed as “medical practitioners” by state licensing boards. Federal laws do not govern the quality of speciality training or regulate the procedures a physician may aspire to perform in his or her practice. This means that any medical school graduate can claim to be a specialist in the area of his or her own choosing regardless of whether of not he or she has legitimate residency training in that area.

Medical directors, managed care executives, credentialing committees, and hospital administrators have a responsibility to ensure that patients are treated by qualified doctors and surgeons. The granting of clinical privileges to various physicians by verification of their credentials allows a hospital or health plan provider to assure its patients and members of the training of its physicians. The following information is a brief overview of the guidelines provided by the American Society of Plastic Surgeons (ASPS) regarding the skills and qualifications that plastic surgeons should have in order to be considered legitimate.

Plastic Surgery deals with the repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, cranio-maxillofacial structures, hands, extremities, breast and trunk, and external genitalia. It uses aesthetic surgical procedures to improve undesirable or counterproductive qualities of these anatomical structures.

Special skills and knowledge in the design and surgery of grafts, flaps, free tissue transfer, and replantation is essential. Competence in dealing with complex wounds, the use of implantable materials, and tumor surgery is also absolutely necessary. Plastic surgery has been prominent in the development of techniques such as microvascular and cranio-maxillofacial surgery, liposuction, and tissue transfer. Competency in plastic surgery implies a combination of basic knowledge, surgical judgement, technical expertise, ethics, and interpersonal skills to achieve satisfactory patient relationships.

Being a member of the American Board of Plastic Surgery-which is a member board of the American Board of Medical Specialities-is an important qualifier for those who request plastic surgery privileges. Qualifying physicians are certified and known as diplomates of the American Board of Plastic Surgery, Inc.

The main purposes of the American Board of Plastic Surgery are:

1. 1.To establish requirements for the qualifications of applicants who request a certificate of their ability as plastic surgeons.
2. To conduct examinations of approved candidates who seek certification by the Board.
3. To issue certificates to those individuals who meet the Board’s requirements by passing respective examinations.
4. To do and engage in any and all lawful activities that may be incidental or reasonably related to any of the foregoing purposes.

Certificates issued by the Board should not be considered degrees as the American Board of Plastic Surgery is not an educational institution. Certification through this board does not give a doctor legal qualification or license to practice any form of medicine; however, doctors certified by this institution are required to have legal qualification to practice medicine in order to become certified.

Certificates of added qualification, or CAQ, provide board certified surgeons with a way to highlight their interest in a specific area. Hand surgery is the only area in which the ABPS offers a CAQ. However, treatment and management of hand diseases and trauma are an integral part of plastic surgery residency training.

Individuals who are certified by the American Board of Plastic Surgery and members of the American Society of Plastic Surgeons have completed several hours of rigorous training in their field as well as been carefully evaluated by their peers from both technical and ethical perspectives of their practice of plastic surgery.

Certified plastic surgeons should have the knowledge and skill to perform most types of plastic surgery with competence and skill regardless of his or her particular area of interest. A certified surgeon should also be eligible for clinical privileges at all hospitals, clinics, managed care facilities, military medical facilities, and third-party payment organizations in operation in the United States and Canada.

Continuing medical education is very important to clinical competence for plastic surgeons. The American Society of Plastic Surgeons requires 150 hours every 3 years of continuing medical education from its certified members, a minimum of 50 which must be related to the practice and discipline of plastic surgery.