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What to do about those confounding application gaps

Credentialing Resource Center Connection, July 14, 2004

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Dear credentialing colleague:
 
The application is received and it seems complete, but upon closer review the medical staff services professional (MSSP) or department chair discovers a "gap" in the dates of prior practice, education, or training.

So, the MSSP prepares a business-like letter and sends it to the applicant requesting complete information to explain the gap. A few days or weeks later, the MSSP receives a letter stating that the applicant had simply taken time off to have a baby, tour the Himalayas, or reestablish the family business after the death of a parent. Or perhaps the applicant says he or she was unemployed and looking for a position, or that the gap is none of your business and was of a personal nature. While waiting for this letter, the MSSP has confirmed all other information in the application with appropriate sources. Now how do you verify the explanation of the "gap"?

First, there is little question that as part of the credentials process you must verify the applicant's activities during the gap. Unfortunately, you cannot simply accept the applicant's explanation. If this were the case, the entire process of verification would be unnecessary. Experienced credentialing professionals know too well that some percentage of applications contain outright falsifications or omissions.

Second, the burden is always on the physician applicant to produce any information deemed necessary to process the application. Check your staff credentials policies to find the applicable language, it is sure to be there.

Third, draft an appropriate letter to the applicant explaining that you will need further information confirming the original explanation. Such information could be in the form of letters from responsible individuals confirming the applicant's version of events. For example, you could accept a letter that says: "I have known Dr. Smith for many years and am pleased to confirm that she did in fact take a year off from practice to have a baby. I am pleased to report that both baby and Mom are doing fine.  If you have any question please do not hesitate to call me."

Or perhaps information from the applicant himself confirms the information.  "Enclosed you will find copies of correspondence between me and Professional Recruiters Inc. This information clearly shows that I have been actively searching for a position in healthcare." Alternatively, you may not hear from the applicant again. Occasionally, you may receive information from the applicant explaining that while he or she indicated they were on sabbatical, the location was Leavenworth where they practiced in the infirmary.

Regardless of the information received or its source, your work is not yet done. A few telephone calls to sources identified in the correspondence must now confirm that the sender/reference is genuine. Sure it takes effort and time, but that is what good credentials professionals do in order to ensure that no physician is appointed to the staff or granted privileges without evaluation of complete, accurate data concerning the person's education, training and experience.

Of perhaps greater difficulty for the credentials committee or department chair is the task of determining the consequence of the time away from practice once the facts concerning the gap are known with certainty. More on this next week.
 
 
That's it for today.

All the best,
Hugh Greeley
www.greeley.com/seminars

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