Hospital Recredentialing and the Solo Dilemma

Musings of a Dinosaur is a blog written by a solo family practice physician. In a recent post Dr. Dinosaur shares his thoughts about the biennial hospital recredentialing process from a physician's perspective: 

The other day I got a big, fat envelope in the mail containing my biennial re-credentialing packet from the hospital. I know I have to go through this whole rigamarole on a regular basis. Most insurance companies require it every two or three years, and so does the hospital. But whoever needs it, it's always a pain.

...This time around there's something new:

If you have had no clinical activity [at the hospital] in the last two years, you must submit the enclosed Clinical Evaluation, to be completed by a peer or associate.

"Solo" means "alone." No other medical professional in the office. No one. How can anyone fill out a form like that meaningfully? Oh, I can probably find a buddy somewhere to sign it and send it in, but this whole episode has got me thinking about several things.

I know I am competent; that I keep up to date; that my charts are wonderful, my patients love me, and my outcomes at least average. At least I think I know this. I believe it, at any rate. But realistically, with no one else in the office (short of an actual observer coming into the office, watching me interact with patients and auditing my charts), how can I prove this? I could be a complete schmuck, and no one would ever know.

Read the full text of Solo Dilemma:
http://dinosaurmusings.blogspot.com/2007/05/solo-dilemma.html

Note the comments after the post, including this one from me:

As a person who until recently worked in the field of Medical Staff Services, I have sympathy for both sides on this issue.

Yes, filling out all the redundant paperwork for hospitals and managed care plans must be painful, I know I'd hate to do it. On the other hand, imagine being the person in the medical staff office who must prepare and mail hundreds of those packets and then carefully review each of them when they come back. I can vouch that that too is a painful process.

Over the past fifteen years or so, federal regulations and accreditation standards pertaining to the medical staff have increased enormously - not to mention the potential for litigation on all sides (thus the two-page tiny-print release form). The goal of course is to weed out those (few) bad doctors you mentioned, and to assure that the physicians on your staff have maintained clinical competence, which is a much more challenging goal to meet.

Everyone agrees with the goals, and nearly everyone agrees that the process has considerable room for improvement.

Perhaps your best course of action would be to request a seat on the Credentials Committee. Learn the system from the inside and then offer suggestions for ways to streamline the process.