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Q&A: Should applicants and/or current medical staff members be able to read their letters of reference?

Credentialing & Verification Update, January 16, 2008

A: If a hospital promises a reference that his or her letter will not be shared, then of course that needs to be respected. As a practical matter, most references would probably prefer that organizations don't share their letters, allowing them to  be comfortable and give a candid response.

The fact that a state's peer review privilege may protect the reference from being sued by the applicant is generally not something that provides the reference with great comfort. However, if a hospital intends to deny an application based in whole or in part upon a reference, the organization must permit the practitioner to see the reference in order to have an opportunity to rebut it.

The best practice for balancing the rights of each party is as follows: The institution needs to have a policy of either disclosure or nondisclosure to the practitioner, and must ensure that all references are aware of all aspects of the policy. If the policy is nondisclosure, then it needs to further provide that in the event the medical executive committee (MEC) or board intends to rely upon a reference as the basis of an adverse recommendation or action, the MEC and board will need to obtain the reference's consent to use this reference's information during fair hearing proceedings.

Editor's note: Catherine Ballard, JD, a partner at Bricker & Eckler in Columbus, OH, fielded this question. It originally ran in the February issue of Briefings on Credentialing, published by HCPro, Inc.

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