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Physicians' role in the credentialing process

Credentialing Resource Center Connection, December 10, 2003

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Dear Credentialing Colleague:

I am often asked to explain the role of credentials committee members and department chairs in the credentialing process. Today, a significant amount of real credentialing work takes place behind the scenes in the office of the medical staff services manager or the vice president of medical affairs. In many well-organized hospitals, most problem applications do not reach the chairperson, let alone the credentials committee. Have the functions of these committees become purely ceremonial or an exercise carried out to comply with antiquated requirements?

The answer to these questions is a resounding "No"! However, there are a few antiquated credentialing requirements that have nothing to do with determining current clinical competence.

Physicians serve the following important roles in the credentialing process:

1. Physicians help continually define and refine the rules and policies that guide the entire process, which ensures that clinical concerns are the only "drivers" of the process to determine actual competence. (Of course, such rules must be reviewed and adopted by the board of directors.

2. It is important for senior physician leaders to critically review all applications for appointment and clinical privileges. These individuals bring a healthy dose of intuitive ability, measured skepticism, high integrity, honesty, and empathy to the review. (Much as would a manager interviewing a potential hire.)

3. Physicians help the organization stay abreast of current literature dealing with the many complexities of medical practice and competence as it relates to quality. Physicians can also relate this literature to the credentialing process and its outcome. Each month researchers publish materials that should affect our credentials programs -- new technology is presented, the impact of impairment on quality is discussed, the relationship between practice volume and outcome is debated (go to http://www.credentialinfo.com/common/emailnls/credconn-arc.cfm to see last week's Credentialing Connection), and legal precedents unfold that could directly affect credentials decisions and policies.

Yes, the role of physicians in the credentials process is great and necessary, which is why the credentials committees should be composed of highly experienced "credentials experts." It is also one of the most persuasive reasons to evaluate hospitals' tradition of electing department chairs to relatively short annual or biannual terms as opposed to longer terms that permit him or her to acquire leadership experience. It is, after all, a rare business that replaces an excellent manager simply because he or she has served two years.

That's it for today,

All the best,

Hugh Greeley

http://www.greeley.com/seminars/

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