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Two-year reappointment is crucial

Credentialing Resource Center Connection, September 3, 2003

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Dear Credentialing Colleague:

I often hear physicians and medical staff services professionals question the need for reappointment every two years. They often give the following reasons:

- Many medical staff offices continually re-verify licensure
- A lot of credentials information does not change within a two-year period (e.g., board status, medical school graduation, residency completion)
- Medical staff quality improvement programs constantly monitor physicians' performance, so if anything negative were identified, action would be taken immediately

All of these points are valid, but unconvincing. Unfortunately, not all physicians are subject to rigorous ongoing monitoring. We do not yet have a satisfactory "data alert system" for licensure actions, malpractice cases, and government sanctions that crop up unexpectedly. In urban settings, physicians often maintain affiliations with multiple hospitals, and no hospital has the resources to monitor each of those affiliations.

But perhaps most importantly, we should retain biannual reappointment to avoid privilege restrictions and denials. It gives the medical staff the chance to re-evaluate a physician's clinical ability to keep performing particular procedures and treatments. It's also an ideal time to provide physicians with feedback regarding his or her contributions to the institution, the medical staff, and the community.

Just as employees' annual (or biannual) performance evaluations set an important tone, so do reappointments. In the absence of true continuous feedback and supervision, reappointment forces us to take stock and reaffirm the commitment between the physician and the institution.

That's all for this week.

All the best,

Hugh Greeley

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