Few events generate as much acrimony between surgeons and hospitals as exclusive credentialing, which is when a hospital revokes, refuses to renew or outright denies operating privileges to surgeons on account of economic criteria unrelated to quality of care. This commonly occurs when a physician has an ownership interest in or is compensated by a competing facility. Here are a few pre-litigation strategies that physician-investors might use to combat or forestall the implementation of exclusive credentialing policies.