Since the seminal decision Darling v. Charleston Community Memorial Hospital (1965) was issued, approximately 40 states have adopted this liability standard. Sometimes referred to as “negligent hiring or selection” or “negligent retention,” this duty applies not only to hospitals but also to managed care entities, such as physician-hospital organizations and independent practice associations. Similarly, The Joint Commission, other hospital accrediting bodies, and state licensing boards impose clear and detailed obligations on hospitals and medical staffs to vet physicians’ qualifications at the time of appointment and reappointment and to continuously monitor their practices to ensure ongoing compliance with accepted standards of patient care services.