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Resolving practitioner health questions

Credentialing Resource Center Connection, January 15, 2009

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Anne R. Buss, CPMSM, CPCS, is a medical staff consultant based in Fayetteville, AR.

Dear credentialing colleague,
  
Last week, a number of us in the credentialing office had a discussion regarding a physician health issue. I asked my colleagues to share their opinions regarding a physician who voluntarily relinquished clinical privileges because of an arthritic condition. The physician had received medical treatment and had recently reapplied for clinical privileges. However, I had the following practical concerns regarding the reapplication:  

• Did the physician need a practitioner wellness file?
• Did we need a statement from the physician’s physician?
• Did the physician require follow-up? If so, what and how often?

Each of us had opinions as to which existing policy should apply to this practitioner. The following are some of the options:

• The medical staff has a practitioner health committee, and it provides regular educational programs on stress, substance abuse, and general health issues. 
• In the leave of absence policy, there is a process for returning to practice following a leave for treatment.
• In the impaired physician policy there are procedures for voicing concerns, investigating, and the appropriate corrective actions for the safety of patients, organization members, and others in the facility.

But what about the physician who self reports a health issue? Can one policy fit all? The Joint Commission Resources suggests there should be two policies because not all impairments are substance abuse related. Physical impairments can be more difficult address. The physician with a health or injury related ability impairment may not be the easiest to cover in a policy or process. The medical staff organization has flexibility in dealing with members self-referrals and treatment options. In this instance, this issue was forwarded to the chairman of the practitioner wellness committee for his direction. The committee members have the clinical knowledge, and do not have a problem with sitting down with a colleague and having an informal discussion regarding these kinds of matters.    

Remember, those who are afraid to ask are afraid to learn.

All the best,
Anne R. Buss, CPMSM, CPCS

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