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Reader tips: Determining how far back to verify employment history

Credentialing & Verification Update, April 9, 2008

In the March 12 issue of CVU, we ran a segment discussing the often-controversial issue of how far back into a practitioner's past to delve with regard to employment and/or appointment history. It was noted that some credentialing specialists feel that verifying a practitioner's entire career when attempting to assess current clinical competence is not useful.

In this issue, CVU shares reader feedback on the topic:

• We verify the dates of affiliation, whether there were any disciplinary actions, and/or whether the practitioner was in good standing at the facility for all affiliations--from medical school graduation to the time of application. We feel that at least there is documentation of time and no gaps in history. We rely on clinical competence data from peer references, program directors if the applicant is a recent graduate (less than three years), and/or the most recent hospital affiliation.
  -Sandra K. Dill, CPMSM, CPCS; director of medical staff services; Cooper University Hospital; Camden, NJ 
  
  
• We evaluated the "valued added" aspect of querying all work history and find that the most value-added information comes from a practitioner's peers, not the work history. Work history just provides status and dates, and many organizations never divulge any adverse information. (If there is any, they routinely state "check the NPDB.") Querying every place a practitioner ever worked works out to a paper chase with little value and strain on resources, and extends the time it takes to credential. 
  
  We do query work history for the past five years. We query the peers that the practitioner provided, and also query the department chair at their active facilities to get a true evaluation of current competency. With the continuing lack of resources and demands to credential faster, I believe it's more important (and money better spent) to have a well-trained credentialist that can identify problematic applications.
  
  Regarding work history, I think the credentialist must articulate what it is they want to learn and think about the best way to obtain it. If there are gaps in practice, work history is not the best way since a letter often shows only that someone was on staff over a certain period of time. If it's current competency the credentialist is looking for, it's better done with a reference letter. 
  -Maggie Palmer, MSA, CPMSM, CPCS; director, Scripps Centralized Credentialing Services; San Diego, CA
  
  
  
• The primary reason that we verify as much data as possible--from completion of training to present--is to verify the information provided in the application or on the curriculum vitae (i.e., to confirm the reported time periods and determine if any unreported gaps in practice exist that would require further explanation from the practitioner. It was once posed that if we're not willing to verify the answer, then don't ask the question. And we do ask about all previous affiliations. We do not consider previous affiliations as primarily related to verification of current clinical competency.
  -Laura Cullen, CPMSM, CPCS; manager, medical staff services; Harris Methodist Southwest; Fort Worth, TX
  
  
• Providers move around far more now than they did 10, 20, or 30 years ago. Hospitals close, merge, or change names and, in some instances, change addresses. Unless the applying provider has maintained current contact information and made it available to the credentialing staff, the process of verifying all previous affiliations can be a daunting task at best and can frustrate the applicant at worst. Take into account the FTEs required to respond to queries; verifying a 20-year window would add significantly to their work load. As we learn to "do more with less," it seems reasonable to set a limit as to how far into the past one should verify.
  
  Credentialing is an art as much as a science; if red flags warrant greater scrutiny, defer the file until all verifications have been received.
  -Susan Manion-Galloway, RT, BBA, CPMSM, CPCS; Piedmont Newnan Hospital; Newnan, GA

Finally, one reader poses a question for fellow MSPs:

• Would we also be expected to verify past work history at various outpatient clinics, surgery centers, and private practice locations? I have found that many times these type of locations have closed or have been sold. If you find one still operating, the information is skimpy. If you can verify all hospital affiliatons with no time gaps, is that sufficient information?
  Send your response or any other tips on employment history to mcoler@hcpro.com.

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