Appointing a Quality Physician

A CUMBERSOME PHYSICIAN APPROVAL PROCESS ADDS CONFUSION AND EXTRA TIME TO ONBOARDING

In this post, Hugh Greeley takes a look at the steps, individuals, and committees involved in the credentialing process. It’s currently an involved and antiquated process including many non-essential elements and expendable steps currently at play in the average onboarding process.

It’s common to have an application pass through far more hands than is necessary and be taken into consideration by people untrained in credentialing. As hospitals work toward streamlining administrative procedures to optimize productivity, the hope is that the process will take less time and effort from busy individuals and rely on solid data before ever reaching committees and boards.

In today’s data-rich, automated technological advances, the first steps should always be that of obvious elimination. It is simple to check for red flags connected to a provider before the review process ever begins.

Imagine reducing the applicant load by a significant percentage before engaging committees, boards, and chiefs?

The following provided by Hugh Greeley, author of Hugh’s Credentialing Digest

HOW MANY DOES IT TAKE TO APPOINT A GOOD PHYSICIAN TO THE MEDICAL STAFF?

This question is often asked in one of the following contexts:

1. How many credentials’ coordinators should we have?
2. How many should be on the credentials committee?
3. What should the required quorum be for the medical executive committee (MEC)?
4. Must the entire board of directors vote on each applicant?

Let’s look at what we know is needed to do the job well: an applicant (to furnish information); a coordinator to confirm and gather information; a person to review collected information and make a decision.

We inherently know that this is what is needed to do the job well because this is the process used by the majority of businesses and industries to make a decision about acquiring/employing a needed person. This is how it is done for nurses, lawyers, teachers, pilots, physicians joining groups, chief operating officers, carpenters, nuclear physicists, journalists, police officers, military personnel, etc.

LET’S EXAMINE HOW WE MAKE A DECISION TO APPOINT A GOOD PHYSICIAN

First, we have an applicant, and then a well-trained and experienced credentials coordinator/medical staff services professional (MSP). Next, we have an often not-well-trained department chair. Then comes a gaggle (anywhere from four to 15) members of a credentials committee (which nearly always accepts the recommendation of the department chair).

Next, there are the members of the MEC, who pretty much rubber-stamp the recommendation of the credentials committee. And finally, anywhere from three to 100 members of the board of directors become involved. It is possible that in some hospitals more than 100 (but more likely about 30) individuals participate in making the decision to appoint a physician.

The only explanation for this excess of review and activity is tradition and extremely outdated requirements. Early on in the evolution of credentialing, the entire active staff voted on applicants, much as was the practice of social organizations such as Lions Clubs, the Masons, country clubs, and medical societies. This practice transitioned in the 1960s and 1970s to having the department cast votes, and from there, to requiring that the chair, credentials committee, MEC, and the board vote.

The role of the chair is hard-written in accreditation standards, as are the roles of the MEC and board. Inexplicably, there is no mandated role for the chief medical officer or CEO (two individuals one would think would have a great interest in seeing to it that only competent physicians are appointed to the staff).

Yet many medical staffs and hospitals have labored to streamline the system by creating modified quorum requirements, making review by the credentials committee optional, and granting authority to a small subcommittee of the board to act for the board.

Many other staffs cling to the concept that it takes an army to determine if a physician candidate is indeed good.

At some point in the future, this will change as hospitals and its staff recognize the lack of value-added through the existing process and begin to act in a manner more analogous to that of other businesses and industries. The only reason the existing system continues to hold sway is that it is propped up by requirements that were created in a different era and for purposes that no longer exist.

POSTSCRIPT: MORE PEOPLE IN THE MIX DOESN’T TRANSLATE INTO BETTER DECISIONS

As a first step to demonstrate respect for everyone’s time and the process, pre-screening all applicants for license status and exclusion from Medicaid or Medicare participation, and other critical data points will assure that only viable applicants are brought to the committee for initial review.

With Verisys’ choices for pre-screening, real-time results are available on the day of committee meetings and can reduce the time and energy reviewing applications that should not be considered in the first place.

Verisys Connect^® is Verisys’ self-service data search portal that provides real-time data solutions to check current and historical national license status, history of disciplinary actions, exclusions, debarments, sanctions, and other critical primary source data such as criminal and abuse records. The data sources include FACIS^®, Verisys’ proprietary data set of more than 8 million records current and historical, tapping more than 3,500 primary sources. Additional primary source publishers include national abuse and sex offender registries, OFAC, and Social Security-Death Master File.

CheckMedic^® is the enterprise-wide, turn-key solution to screening, credentials verification, and continuous monitoring against more than 3,500 primary sources including FACIS^®. CheckMedic^® issues a MedPass^® to each provider and employee as a comprehensive digital credentialing profile for all data, credentials, peer reviews, board certifications, license status and history, and other relevant data. The MedPass^® is a secure, portable digital credentials profile and has custom alerts for expirations, CEU requirements, and actionable adverse actions.

Also, the e-book, “Closing the Five Critical Gaps in Health Care Screening, Verification and Monitoring for Credentialing” reveals the data solutions that close the data gaps so often missed and that contribute to organizational risk.

Written by Hugh Greeley Credentialing and Healthcare Industry Expert HG Healthcare Consultant Connect with Hugh