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Criminal background checks are an essential credentialing tool

Credentialing Resource Center Connection, October 27, 2004

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Dear credentials colleague,

If your hospital is one of the 30 to 35 percent of the nation's hospitals that already conducts a criminal background check as a routine part of the initial credentialing process, then read no further. Congratulations.

If, however, you are among the majority of acute care facilities in the nation that do not, you may want to add this simple background check to your existing credentials procedures.

According a front page article in the Oct. 19 issue of USA Today (www.usatoday.com), a large percentage of physicians with criminal backgrounds are unlikely to acknowledge this fact when filling out an application. In fact, an omission or falsification in regard to criminal background is more likely to occur than one involving medical school or residency records, or previous licensure problems. As you know, we all take great pains to verify these pieces of information.

While the mere presence of a criminal background may not disqualify an individual for medical staff appointment or clinical privileges, this information is certainly something that a credentials committee would want to know. Knowledge of all the facts permits the credentials committee to make a reasonable evaluation of the applicant's qualification for medical staff appointment.

Without verifying the criminal background information on a physician's application, credentials committee must realize that they are:

1. assuming that all physicians answer all questions truthfully (an assumption that we know is incorrect)

2. assuming that other background checks, such as license, education, training, references, etc., will alert us to an applicant's criminal background (another assumption we know to be false)

Most states do not conduct criminal background checks as part of the licensure process. Similarly, the majority of the nation's medical schools do not conduct criminal background checks as a prerequisite to enrollment, nor do residency programs.

Most individuals providing a professional reference for an applicant are unlikely to know whether or not the applicant has a criminal background. Also, neither the Office of Inspector General nor the National Practitioner Data Bank currently maintains information on prior criminal convictions.

Therefore, the task of verifying an applicant's past criminal records rests with the hospital's credentialing process. This may be old hat for hospitals or companies in those states where criminal background checks are required for all healthcare practitioners, but a criminal background check can be an essential tool.

As a credentials professional your job is to make certain that your institution is making a reasonable effort to ensure that staff appointees have undergone a comprehensive evaluation of their education, training, experience and current clinical competence. A criminal background check is a vital component in today's evaluation process.

That's it for today.

Hugh Greeley

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