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Looking between the gaps.

Credentialing Resource Center Connection, December 2, 2004

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Dear credentials colleague;

When reviewing an application or reapplication, one factor to be on the lookout for is the presence of gaps in the physician's background or experience.  Gaps can come in many forms such as breaks in formal education or training, a hiatus in practice, periods where the applicant appears to have had no hospital affiliation, and periods where there is no accounting for the physician's whereabouts.

If such gaps are acknowledged and explained on the application, your process is fairly straightforward.  Explanations for all gaps in training or practice must be verified during the credentialing process through independent sources.  If, however, you have uncovered an undisclosed gap, even though your application made it clear that all gaps must be accounted for, the process may become more complicated.  The following general principles may be of use in determining your next move.

If an applicant has failed to report a gap identified by your independent research, your position could be either to:

1. Request a full explanation from the applicant including why he/she failed to report the gap on the application, while reserving the right to terminate the application process if you determine that the omission was deliberate and substantive.

2. Evaluate the circumstances and, if appropriate, immediately terminate the process with no right to a hearing. (For example, an obvious attempt to deceive your credentialing process such as an applicant not disclosing a period spent not practicing while fighting a corrective action taken by another health care organization.)

Once again, good policies and procedures coupled with an excellent credentialing professional and an experienced chair or vice president of medical affairs will allow your facility to easily deal with an undisclosed gap.  But be tough.  Avoid the human tendency to give the applicant another chance and don't make the applicant's problem your own.

That's all for today

Hugh Greeley

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