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What to do when a physician resigns during an investigation

Credentialing Resource Center Connection, April 28, 2003

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Dear Credentialing Colleague:

"I'm fed up! Consider this my resignation. I'm out of here!"

A physician made this verbal proclamation to the chief of staff just after he learned that a special committee would investigate his clinical work. Apparently, the medical staff had serious concerns about the necessity of some surgical procedures performed by this physician. After nearly three months of "routine" peer review at the department level, the department chair requested a formal investigation in accordance with medical staff bylaws. The medical executive committee impaneled a special investigative committee and notified the physician.

Rather than hang around for the results of the investigation, the physician resigned from the medical staff and left town. The chief of staff now has two questions to answer: one easy, one more complex.

The first question: "Should we report this resignation to the National Practitioner Data Bank?" Unquestionably, the answer is "yes." This physician resigned during an investigation that could have led to restrictions or the revocation of his clinical privileges. It is clearly a reportable event.

The second question: "Should the medical staff continue with its investigation to create a full record of its concerns, deliberations, and findings in case the physician ever returns?"

The medical staff need not continue with this investigation unless it has a strong desire to do so. It should, however, place a formal letter or report in this physician's credentials file explaining that he resigned during an ongoing investigation. The hospital should maintain the details of the medical staff's concern, including patient record numbers, in this report or as part of the confidential peer review file "just in case" the physician has a change of heart and decides to return. The report should also note the fact that the physician delivered a "verbal resignation" to the chief of staff that was accepted by the MEC and board.

If this physician should return in the future, he should be notified that the medical staff office would not process his application until he has resolved all of the issues relevant to the quality of his previous work at the hospital.

That's all for this week.

All the best,

Hugh Greeley

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