The association defines the term as "the use of economic criteria unrelated to quality of care or professional competence in determining a physician's qualifications for initial or continuing hospital medical staff membership or privileges."
Traditionally, physicians applied for hospital staff membership based on education, medical licensure and a record of quality care.
For example, an obstetrician and a family practitioner might request privileges for both routine deliveries and caesarean sections.
The FP might obtain both procedures or be restricted to routine deliveries only, or none at all, based on hospital policy.
Some hospitals have seen this as a threat to their economic interests and have denied or revoked membership and privileges of the physician owners.