Weaknesses in Medical Vetting - Letters to the Editor

The recent Wall Street Journal article "Weaknesses in Medical Vetting" is featured over on A Chance to Cut is a Chance to Cure, where a couple of letters to the editor are posted. 

A physician from Knoxville, TN writes "the bad apple cuts a deal and moves to another state, safe in knowing that it is illegal for the old hospital to tell the new hospital what happened."  I think we can safely state, especially in view of the recent Kadlec case, that there is nothing illegal about hospitals sharing information.  That having been said, we know that being legal doesn't necessarily mean that important information is always shared.  Fear of legal reprisal, concern that we might somehow unfairly harm a physician's reputation and ability to practice, and frankly, just plain laziness in the form of taking 'the easy way out' all factor in to the lack of meaningful information flow between organizations.

Dr. Burns also expresses frustration over the need to follow bylaws, which he says "hamstring the medical staff and delay suspension of the troublemaker while more patients suffer."  As anyone who has ever participated in review of a poor practitioner or seriously bad outcome can attest, well-written bylaws are a key component.  However, even overly-complex bylaws can interject some logic and help keep the participants from reacting on emotion alone.

The second letter, from a surgeon in Dallas, Texas includes a statement that I imagine will ring true for most of us who work within the credentialing process.   "Too often, hospital peer-review committees are left to deal with physicians practicing outside accepted standards whose initial credentialing process was "shepherded" by an overzealous administrator wanting to add new medical "product lines" or an established medical group eager to take on a new partner." In fairness to those "overzealous administrators" this issue, like following bylaws, is a double-edged sword.  Effective credentialing takes time, time costs money, and administrators are charged with financial oversight.

The maelstrom surrounding John Anderson King, M.D, should make every organization that credentials practitioners examine their processes and attitudes. If each of us involved in this vital task work toward the goals of patient and organization safety first, while respecting the need for financial efficiency and growth, we can increase the odds of someone like Dr. King being weeded out before he takes root.

Blogs commenting on this case:

A Chance to Cut is a Chance to Cure
http://cut-to-cure.blogspot.com/2005/10/letters-to-editor.html
http://cut-to-cure.blogspot.com/2005/10/when-your-credentials-committee-fails.html

Red State Moron
http://redstatemoron.typepad.com/red_state_moron/2005/10/no_specialist_i.html

Aggravated DocSurg
http://docsurg.blogspot.com/2005/10/go-read-great-post.html

MSSPNexus
http://msspnexus.blogs.com/mspblog/2005/09/wall_street_jou.html

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