Processing a physician's application for membership and privileges on a hospital medical staff involves a myriad of steps, and can take weeks or even months to complete. Primary, and sometimes secondary source documents that prove that the individual making the application has gone to medical school, has a license, is indeed board certified if that claim is made on the application, etc. are collected. Time lines may be developed to assure that no significant period remains undocumented. Credentialing generally also includes contacting peers and other professional references with questions about the applicant's skills, abilities, character and competence to perform requested privileges.
All of this data is reviewed first by the medical staff professional(s) responsible for collecting and analyzing it. It is then presented to medical staff and administrative leadership, usually in the form of a Credentials Committee meeting. Sometimes applicants appear for personal interviews at those meetings. Final decisions are made by the governing board.
As any member of a Credentials or Medical Executive Committee will tell you, making wise recommendations about medical staff applicants is a complex and weighty task. It is a key foundation to patient safety. Some applicants are the proverbial "no brainers." Welcome to our medical staff; glad you're here. Others require considerable discussion and perhaps further investigation.
The importance of thorough documentation, not just of the process of collecting information, but also of the deliberation and discussion that occurs at Credentials, Medical Executive, and Board meetings is well illustrated by a case featured in a May 7, 2007 Medical Economics article:
Negligent credentialing: Is the danger growing?
It's complicated enough when a patient who's been injured in the hospital sues her treating physician, but it gets more complicated still when she also sues the hospital for credentialing that physician in the first place.
Among recent cases, none illustrates the issues connected with negligent credentialing better than Larson v. Wasemiller.
What's most important is the process that the hospital followed: What information did the committee consider and how did it consider it? What discussions among members took place? Given the information it had, why did the committee reach the decision it did? These are the critical questions that the hospital just can't talk about, can't fully provide evidence about.
Meanwhile, both physicians and hospitals have been put on notice that failure to take the credentialing process seriously—whether because some physicians have been less than truthful before a committee, a committee has been less than vigilant in its review, or the hospital itself has been less than candid in its communications with another hospital about a physician—can be legally risky, says Philadelphia's Robin Locke Nagele.
Read the full text of the article in Medical Economics
Hat tip to Dr. J's House Calls
Comments