Credentialing & Privileging

Fulfilling your potential as a medical staff professional

Credentialing Resource Center Connection, September 6, 2007

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Sally J. Pelletier, CPMSM, CPCS, is a consultant with The Greeley Company, a division of HCPro, Inc., specializing in the areas of credentialing and privileging.

Dear credentialing colleague:

When was the last time you stopped to think about the value that you, as an MSP, bring to your medical staff? If you haven't conducted a self-assessment lately, here are some questions that you may want to ask yourself:

  • What do you do to make the medical staff's role in credentialing and privileging easier?
  • Are you proactive or reactive to new standards and regulations? 
  • Are you mindful of what is cutting edge or best practice in the industry and are you making suggestions as to how those things might benefit your own organization?
  • When reviewing the Joint Commission (formerly JCAHO) standards (you do review them, right?) do you flip only to the medical staff standards related to credentialing and privileging sections and stop there, or do you become familiar with other standards that have an impact on the medical staff such as the leadership and performance improvement standards? 
  • Do you know what is in your medical staff bylaws and actively use them as your road map for dealing with medical staff issues?

It is also important to reflect on the areas where you could expand your circle of knowledge simply by having a more open mind to listening and learning at meetings. Take a moment out of your schedule to research your state regulations or network with your peers to get a feel for what is new and innovative. Do you ever read an article that offers a tried and true approach to a problem your office is having and ask yourself how you could apply it to your current situation? Don't just think about making changes-make them, and fulfill your potential as an MSP.

When advocating for the profession, we all want to think of the MSP as being similar to air traffic controllers-behind the scenes, but of immense and unquestionable value. The airline industry would come to a halt without them. They are well trained, concerned for the crew and passenger's safety, and must be able to anticipate and provide solutions to potential problems. They do not wait for the pilot or co-pilot to suggest solutions; they have already provided the answers that are needed based on their skills and experience. Like the air traffic controller, the MSP should strive to be the best possible resource that he or she can be for his or her organization and medical staff leaders: concerned for patient's safety, able to anticipate challenges, and willing to provide the best solutions from a risk management perspective.

There are certainly a great majority of MSPs who provide this level of sophistication and aptitude in many organizations across the country. However, not all MSPs are created equal. I once heard an MSP state, in all seriousness, that she doesn't need to be aware of new happenings in the industry, or changes in Joint Commission standards, or state law until her credentials committee brings it to her attention because, "that is their job, not mine". This particular MSP has relied on the credentials committee and other medical staff leaders to take the lead on matters of credentialing and privileging when in fact, she could make herself invaluable to them by providing information regarding new standards, best practices, and potential solutions to complex credentialing and privileging issues.  Instead, for this particular medical staff, it was the other way around. Needless to say this medical staff office operated in crisis-management mode most of the time.

I've also run across medical staff leaders who have this type of MSP in their organization, and because they don't know what they don't know they believe (based on their experience) that the role of the MSP is to take a backseat, perform clerical and administrative functions, and follow rather than lead.

As our time together in NYC at the annual NAMSS conference approaches with its many educational and networking opportunities, and as Medical Staff Services Week draws near with the first week of November with its opportunity to promote the profession, I encourage you to take a moment to ask yourself if you are a proactive or reactive resource for your medical staff leaders. Are you fulfilling your potential as a MSP?  If you don't like the answer, then it's time to make a change.

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,

Sally J. Pelletier, CPMSM, CPCS
http://www.greeley.com/consulting.cfm



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