The problem with courtesy staff is being conditional requires to be active staff in different hospital to monitor physician performance and all other quality issues for credentialing and reapointment. The same is true for associate staff (which we do not have in our hospital). Unless the hospital drop that provision in the bylaw, Those physican have no option except to resign from the medical staff, which is quite traumatic to them since they have been practicing for 25 to 35 years. However they are willing to resign if no other option if they medicare and insurance will allow them as I mentiened before.