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Explain the importance of credentialing to physician leaders

Credentialing Resource Center Connection, January 28, 2003

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Dear Credentialing Colleague:

Last week, a newly appointed credentials committee chair asked me the following question: "Just why should our committee be involved in credentialing? We've never had a bad physician join our staff."

This chair's medical staff services professional (MSSP) was standing next to him at the time. After a wink from her, I responded, "I would have thought this would have been explained to you during your orientation, or even prior to your appointment to the credentials committee."

The MSSP commented, "Oh, Dr. So-and-So was drafted; we can't get anyone to serve in these positions anymore. He's never been on the committee before."

I explained the importance of the credentialing process as follows:

1. Credentialing is primarily performed to protect patients. It is one of the most effective controls in medicine today and probably ranks right up there with residency training as a key to quality.
   
   
2. Credentialing is also performed to protect the hospital and medical staff in case a patient is (or believes he/she has been) injured. Corporate negligence cases often allege that the hospital did not perform the credentialing function well. Good credentialing practices allow your hospital to easily demonstrate that you dotted all of the i's and crossed all of the t's. There's no question that if a hospital and its credentials committee do their jobs well, it becomes very difficult for a plaintiff attorney to demonstrate negligent credentialing.
   
   
3. We credential because it's required to stay in business. The federal government requires it, as does the JCAHO, NCQA, and state laws. If your hospital fails to uphold its credentialing obligation, it will face loss of license, Medicare/Medicaid participation, and accreditation status.
   
   
4. Evaluating one's peers (e.g., via the credentials committee) is one of the oldest principles executed among medical staffs. It dates back to the American College of Surgeons in the early part of the 20th century. Who better than other physicians to determine whether a physician is qualified?
   
   
5. Credentialing is required by your medical staff's bylaws. You might just take a look and see what they say about your job.
   

"Oh, don't worry," replied the MSSP. "I know everything about it. Just follow my lead and I'll you'll be fine."

That's all for this week.

All the best,

Hugh Greeley
www.greeley.com/seminars/

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