Credentialing & Privileging

Those who do not learn from history are bound to repeat history

Credentialing Resource Center Connection, October 4, 2004

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Dear credentialing colleague:
 

Members of the public believe they have a right to expect that the physician providing services to them has had his or her background carefully evaluated by the state licensure board or local hospital.

It is true that most hospitals now conduct a very careful background check and evaluation of all new applicants to their medical staffs. And, while the standard continues to evolve, many now conduct a routine criminal background check in an attempt to verify the applicant's answers to questions concerning criminal history. Such checks are mandatory in a few states. However, they are not required by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) nor are they required by the federal government through the hospital Conditions of Participation. Many medical staffs have included a verification requirement within their credentials policies or bylaws. Some hospitals, recognizing the importance to verify all answers on the application, conduct these checks in much the same way they would screen prospective employees.
 
Unfortunately, patients seeking care in most states have no assurance (based on the fact that the physician is licensed) that their treating physician has not engaged in criminal activity in the past. Those who engage in credentialing, first recognized the need for a criminal background check after the publication of "Blind Eye" by James Stewart, a book that detailed the case of Dr. Michael Swango. Many dismissed Swango, who is now in prison for the murder of patients, as an anomaly. Today we know that he is one of many healthcare practitioners with a criminal background.  In fact, just this month a physician who had failed to disclose his criminal past was identified in South Carolina. Go to www.thestate.com/mld/thestate/9746302.htm for more information on that case.  Unfortunately the disclosure was prompted by an investigation of the physician after a patient had died subsequent to his brand of "alternative medicine".
 
It is not known whether an evaluation of this physician's past criminal activity would have prevented licensure by South Carolina or Wisconsin. What is known is that these states, among many others, assume that physicians are truthful when they complete the application and do not attempt to verify answers concerning past criminal activity. This logic fails. If it were true that all physicians are truthful, a state should not even attempt to verify medical education or residency. If it were true that all physicians are truthful, states would not have to test them prior to licensure. They could simply ask "are you a qualified physician?" Unfortunately, a relatively small percentage but significant number of healthcare professionals are not forthcoming when asked about their past. This is the reason credentials committees and their assistants attempt to verify all answers on the application with an authoritative source.
 
Check your policy. Does your medical executive committee (MEC) and board now require verification of this simple piece of information?  If not, they should. We no longer live in the 1990s. We have access to information via sources that did not exist previously. All of those sources should be used to attempt to assure that patients will be well served.

That's it for this week.

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



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