Prospective proctoring is a review by the proctor of either the patient's chart or the patient personally before treatment. This type of proctoring may be used if the indications for a particular procedure are difficult to determine or if the procedure is particularly risky. Concurrent proctoring is when the proctor actually observes the physician's work. This is usually used for invasive procedures so that the medical staff has first-hand knowledge necessary to satisfy itself that the physician is competent. Retrospective proctoring involves a retrospective review of patient charts by the proctoring physician.
Retrospective review is usually adequate for proctoring of noninvasive procedures.
All initial appointees to the medical staff and all existing medical staff members requesting new privileges should be subject to a period of proctoring, regardless of specialty. In departmentalized hospitals, each department should proctor its own new members or existing members who are requesting new privileges. If there is no suitable proctor within the department, the department will select a proctor from the medical staff or recommend that the hospital obtain a particular proctor from another institution. In non-departmentalized hospitals, proctoring responsibilities should be assigned by the medical executive committee. The proctor should have similar qualifications and be in the same specialty as the applicant.