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UHMS Credentialing and Privileging Guidelines for Hyperbaric Medicine Physicians in the U.S.A.

UHMS Credentialing and Privileging Guidelines For Hyperbaric Medicine Physicians in the U.S.A. 
Revised: 26 June 2014 
Principles Intrinsic to Ensuring Patient Access to Safe, High‐Quality Hyperbaric Oxygen (HBO2) Therapy HBO2 therapy entails medical risks and should be provided only by physicians with specialized training in hyperbaric medicine and facilities properly equipped and maintained to do so.  For physicians, experience in both routine and emergent HBO2 treatment situations is expected.  For facilities, formal accreditation through a facility accreditation program recognized by the Joint Commission, such as the UHMS accreditation program, is recommended.  A 5‐year transition period is recommended to enable all hyperbaric medicine physicians and facilities to meet these certification, privileging and accreditation guidelines.  However, during this transition period, patient access to HBO2 therapy for approved indications should not be limited. 
Minimum Physician Training, Experience and Certification 
Hyperbaric medicine physicians must possess: 
  • An unrestricted medical license as required for the location of their hyperbaric medicine practice
  • Board Certification in a primary discipline of medicine that reflects local medical staff standards
  • Current certification in Advanced Cardiac Life Support  
  • For each of the following specified categories of practice, advanced training and experience in hyperbaric medicine as evidenced by:
    • For Supervised and Proctored Practice:  The minimum requirement is one or both of the following:
      • UHMS‐Approved Hyperbaric Medicine Introductory Course completion (a minimum of 40 hours on‐site)
      • Current participation in an accredited Undersea and Hyperbaric Medicine (UHM) Fellowship or UHMS Certificate of Added Qualification (CAQ)

NOTE:  This is a restricted form of practice.  It is expected that physicians in this category will advance in their formal education toward independent practice within five years.  

    • For Independent Practice:  This category requires certification in hyperbaric medicine by an institution independent of the UHMS (or any other hyperbaric medicine organizations) that is recognized nationally and internationally for conferring physician certifications in primary medical specialties.   Accordingly, the following certifications are acceptable:
      • Board Certification or Board eligibility in UHM conferred by the American Board of Medical Specialties  (ABMS)  or  the  UHM  CAQ  conferred  to  Osteopathic  Physicians  by  the  American Osteopathic Board of Preventive Medicine (a process parallel to ABMS certification). Certification through the ABMS or the AOBMS remains the gold standard for hyperbaric medicine physicians.
      • UHMS  CAQ  in  hyperbaric  medicine  carries  an  independent,  university  accreditation  and  is internationally validated.
      • As an Expert in Hyperbaric Medicine: In the United States, the UHMS recognizes a higher level of expertise, a designation generally limited to physicians who have achieved both certification in hyperbaric medicine by the American Board of Medical Specialties or the Osteopathic equivalent but also have achieved peer recognition for their hyperbaric medicine expertise and experience (as  evidenced  by  their  leadership  in  publication  and  education).  Additionally,  the  UHMS recognizes physicians in this category as advanced trained experts who are ideally suited to act as hyperbaric facility medical directors and/or proctors for those physicians restricted to supervised or proctored hyperbaric medicine practice.  
    • “Experienced Provider Exception”:  The UHMS recognizes that credentialing is the purview of the local medical staff.  Although certification is preferred, local credentialing bodies may waive this requirement by approving  an  exception  (with  or  without  restrictions  on  privileges)  for  experienced  hyperbaric medicine physicians with a documented minimum of 10 years’ experience providing HBO2 therapy for approved treatment indications. 
Other Issues Applicable to Scope of Practice and Privileges 
Privileging should be commensurate with both the hyperbaric medicine physician’s credentials and the practice pattern and capabilities of the hyperbaric facility.  The granting of restricted privileges is appropriate for physicians without hyperbaric medicine certification or advanced training.  Hyperbaric medicine privileges should specify the range of approved indications, chamber types, and degree of patient complexity (e.g. stable, complex, critically ill, ventilated, adult, or pediatric) and the details of any restriction, supervision or proctorship requirements. 
Continuing Medical Education (CME) and Reappointment 
For initial appointment or reappointment, hyperbaric medicine physicians must complete a minimum of either 12 hours of hyperbaric medicine specific category 1 CME each year or a total of 36 hours of CME within the preceding 3‐year period.  If local requirements or the requirements of certification agencies exceed these standards, the CME requirements of the physician’s certification and privileging agencies should be followed.