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Credentialing and human resources

Credentialing Resource Center Connection, January 28, 2004

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Dear Credentialing Colleague:

A few weeks ago I suggested that hospital human resources departments might benefit if they began to employ a few of the techniques used in good credentials programs such as stringent background verifications and insistence upon complete references.

I received a few letters of thanks from "credentialers" and this one from a credentials chair: "Your remarks last week were right on target. Human resource departments should insist on full verification of past employment just like we do. But our committee could take a lesson from human resources as well. If they find that a prospective employee has had a difficult time relating to others, they won't offer employment. If they find that an applicant has lied on his or her application, they won't consider the application further. If they find that the applicant has a spotty track record, they won't hire him or her. If they find that the prospective employee wants to be hired for a position for which he is not qualified, they simply will not further process the application.

"However, if our credentials committee finds similar issues, we will debate adinfinitum and often end up recommending the physician for appointment; after all he's not joining 'my' practice. Why is it that the human resource department is so able to do its job well while we constantly struggle with it?" he continued.

Perhaps there are two explanations. The first is tradition. Credentials committees do not act like human resource departments because historically they were not designed to. When the process was first set up decades ago, credentialing was a "club" activity designed to allow existing club members to review a colleague's professional education, training, and references. It was widely believed that as professionals, physicians would not exaggerate their qualifications, practice poorly, or act in a disruptive manner. Also the legal/ regulatory system allowed denials without the significant ramifications hospitals face today. If an applicant was believed to be unqualified, medical staffs simply said "not in our club" and the applicant went elsewhere. Today, nearly all of the above has changed.

The second explanation is more complex. Hospitals continue to rely upon well-meaning but distracted individuals to perform what is today a very important institutional task. Most of these individuals are not employees of the hospital and have less need for the facility than at any time in the last 50 years. It is not that they do not care about the qualifications of applicants; it is simply easier to be uncritical.

If a solution is needed in this area, it will likely be found through the "professionalization" of the credentials review process, perhaps by staffing the process with individuals who are allied with the institution's mission through either employment or contract.

The parallels are there and so are the differences. In all other businesses, no group of disinterested individuals would be asked to perform such an important task.

That's it for today.

All the best,

Hugh Greeley

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

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