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Reader advice: Determining how far back to verify employment history

Credentialing & Verification Update, May 7, 2008

In the April 9 issue of CVU, we ran a segment that shared reader feedback on the sometimes controversial issue of how far back into a practitioner's past to delve with regard to employment and/or appointment history.

In this issue, CVU shares two readers' responses to an MSP's question:

Q: 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 do find one still operating, the information is very skimpy. If you can verify all hospital affiliatons with no time gaps is that sufficient information?

A: We verify, or at least attempt to verify, all work history for applicants since graduating from medical school. This helps explain any gaps, as a physician may have spent time working in a clinic setting without hospital privileges (something we have encountered). We would want to know this so that we can ensure current competence for the inpatient hospital privileges they are requesting. In addition, we recently credentialed a practitioner who omitted disclosing an employment/work history, which we later uncovered; the practitioner's employment at that office had been terminated due to alcohol/drug problems. Maybe that's why it was omitted. This just emphasized in our credentialing process the need to also verify (or attempt to verify) all work history. The burden is on the applicant.

As a side comment, I am always dismayed when my fellow colleagues cite workload issues and FTEs as the reason for failing to do what I feel is the right thing for patient safety and quality patient care. Although we all suffer from this same form of "disease," we have to find a way to continue to do the right thing and protect patients while working within our own constraints.
Kelli L. Fussell, CPMSM, CPCS
Manager of Medical Staff Services; Salem Hospital, Salem, OR

A:This is in response to the reader question regarding whether it is necessary to query surgery centers, outpatient clinics, etc., if clinical references from peers/hospitals are satisfactory. I feel it should be routine procedure to query clinicians at any facility in which the practitioner provides medical care (i.e., duty to know).

If, in my routine initial credentialing, I discover that the applicant "forgot" to mention he/she is the medical director for an outlying outpatient clinic, I am very apt to receive invaluable information from the mid-levels (PAs/ARNPs) who report to the MD. There may be good reason the applicant neglected to list his/her appointment at the surgery center or the walk-in clinic!

Lastly, my experience suggests that the most valuable references are those not listed on applications. I've discovered that contacting applicants' peers in other specialties (e.g., requesting clinical references on a surgeon from anesthesiologists, from radiologists, etc.) often provides much insight.
Karen W. Clay, CPMSM
Medical Staff Coordinator; Springfield (VT) Hospital

Do you have feedback on this topic or any other related to credentialing or verification? Email your comments to mcoler@hcpro.com.

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