Like any industry, our industry of credentialing continues
to evolve and progress. Many medical
staff professionals can recall old methods and techniques used to verify
credentials in an effort to prove current clinical competency. The depth of verification and the methods
used to gather data continue to evolve, as new resources become available. Personally, I can remember when verifying
education of foreign medical graduates was a tedious process with letters exchanged
in different languages that required interpretation. Today, we rely on the Education Council for
Foreign Medical Graduates (ECFMG) for verification of education in foreign
Recently, it seems the changes in credentialing process have
been in response to case law. Several
cases come to mind immediately. Dr.
Christopher Duntsch has become known in our industry as Dr. Death as many of
his patients died when best credentialing practices were not followed. Dr. William Husel was charged with 25 counts
of murder related to fentanyl overdoses in Ohio in June 2019. Cases such as these create doubt about
patient safety. Our job as medical staff
professionals is to protect the patient against incompetent or criminally
inclined physicians and other non-physician providers.
Due to the notoriety of recent cases involving incompetency
and criminal behavior on the part of providers, it is clear that organizations
will be evaluating and often times deepening their processes to assure they are
comprehensive and effective in order to protect patients, mitigate their
financial risks as well as the risk of a damaged reputation. One way/method to
do this is through the addition of a criminal background check in our
Moreover, as is usually experienced in our industry, there is no
consistency or standardization of this additional step.
In the 2019 Annual Report on Medical Staff Credentialing
conducted by Verity, a HealthStream company, 80.6% of the 591 respondents to
the annual survey indicated centralization and enterprise/industry
standardization were extremely or very important. 90.2% of 317 respondents perform background
checks on new applicants to the medical staff. Of these 82.5% were performed by
the credentialing department/medical staff office.
A recent post of the American Health Lawyers Association (AHLA),
posed a question of the depth of criminal background checks. While some facilities have adopted a criminal
background check required by and limited to Federal and/or State law (often
times in response to a human resources employment verification), other
facilities have adopted policies of 5,
7, or 10 year depth of criminal background history upon initial appointment and
reappointment of the provider. I find
this to be interesting that the depth of the criminal background check at the
time of reappointment often times mimics the same depth as that of initial
appointment even though reappointment is typically required every 2 years.
Standardization and adoption of best practices (depth of criminal
background check and what department is responsible for the criminal background
checks) will be debated in the coming years.
Obviously, the addition of the criminal background check is not
standardized throughout facilities across the country; I believe the addition
of the criminal background check will become a common practice in our
industry. Whether this function is
performed by human resources or embedded in the traditional credentialing and
privileging processes, most criminal
background check laws (Federal and State) are aimed at protecting the facility
from employees with a criminal history (and were not intended to micromanage
hospital’s credentialing/privileging functions as to who is best suited to
practice medicine in certain facilities).