Credentialing & Privileging

Retired physician re-entering the medical staff

Credentialing Resource Center Connection , March 19, 2009

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

Dear credentialing colleague,

A curious situation has occurred in my hospital over the past month: two retired physicians have filled out applications for medical staff membership and clinical privileges. Both physicians have been out of medicine for some time. Our facility faces a dilemma over how we should process them back into their specialty areas because our medical staff bylaws do not address this particular situation.

The bylaws do say that when applying for staff privileges, one is required to have a current medical license, which both of these physicians have. However, their clinical skills are out of date. Additionally, the bylaws require a DEA certificate and malpractice insurance, for which both have applied, and for the practitioner to produce clinical practice data for the past 24 months. This 2 year/24 month timeframe was developed and recommended by the American Board of Medical Specialties (ABMS). Clinical practice data refers to any amount of direct and/or consultative patient care provided. These two physicians have no clinical activity other than a monthly meeting of retired physicians and the CME’s required to keep their licenses current.

While researching this mater further, I checked with our state medical board, and found there were policies in place for re-entry into the workforce. The method for re-entry may vary if the practitioner was practicing in another state during the period of inactivity. The licensee may be required to successfully complete the FLEX “Special Purpose Examination” as administered by the board and/or meet such other requirements the board feels necessary to establish current levels of competency. Other requirements could be a mini-residency, CME’s which are not earned via internet, proctoring, and/or a probationary period. (Note that your state board may have different requirements.)

I found there are a few re-entry programs throughout the U.S., but they are not accessible to our practitioners for reasons due to geography, time, and expense. I am not sure if this re-entry is a growing trend or a coincidence, but given the economic situation in the country at the time, the reasons could be financial as well as boredom. In any case, it is a matter we will continue to research, and one that you may find yourself researching, too.

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

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



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