Physician Credentialing Software Is Out of Control and Borders On Absurd.

Physician credentialing software is out of control and the process just keeps getting crazier.   Physicians currently pay hundreds of dollars a year in regulatory fees.  Doctors pay thousands of dollars to take their national examinations.     These tests are meant to verify physicians as experts in their field of medicine. So why are physicians forced to jump through miles and miles of complicated credentialing processes for every hospital they would like to see patients at?

Physicians must get hospital credentials before they can provide a service at the hospital  If there are five hospitals in town and a  physician wants to see patients at all five hospitals, they must apply for the right to practice medicine at all five hospitals.

**  It's not good enough to pay your money to your state licensing authority every year for the right to practice medicine.

** It's not good enough that most states require physicians to complete at least 50 hours of uncompensated continuing medical education (CME) every two years  just to apply for a state medical license.

** It's not good enough to pay $700 every few years to the federal government for the right to prescribe medications

** It's not good enough to pay several thousand dollars and spend hundreds of hours of uncompensated study to get your board recertification every few years.

Nope, none of that is good enough.  To practice medicine inside the walls of a hospital, the hospital must then grant you the privilege of seeing your patients at their hospital.  Every hospital has their own set of rules.  Every hospital has their own credentialing committee that meets to give the yeah or nay to new staff appointments.  Every hospital has their own physician credentialing software that guides them in their search for red flags.

I recently applied for hospital privileges to another hospital.  Happy's billing company takes care of all the credentialing requirements for insurance companies and hospitals.    In this case, they sent me a packet of information almost 40 pages long.  They mark everything I need to sign with tiny little sticky pads. About 10-15 tiny little sign and date here sticky pads dotted the hospital credentialing paperwork.  It was forty pages of legal mumbo jumbo.

A lot of  this physician credentialing software delves into your past history.  Where did you train? What are your previous practice experiences?  What procedures can you prove proficiency in?  What procedures would you like to be credentialed to provide?  What are your last three residential addresses?  Have you ever been charged with a crime?  Have you ever been convicted of a drug or alcohol related offense?  Have you ever been sued? Not just having lost a lawsuit.   Have you ever been treated for depression?  There is some pretty personal information that gets requested on these hospital credentialing applications. Next thing you know, they'll want to know my sperm count.

Imagine the legal fallout hospitals must be worried about by allowing doctors who have been sued from seeing patients?  Could they be held liable for allowing a bad apple to practice medicine in their walls.  Should they allow a physician who has been licensed by the government and certified by their specialty society as an expert capable of providing excellent care to practice in their hospital?  

There are many ramifications for settling a lawsuit because it's cheaper just to make it go away than to fight for what you believe in.  Would that prevent you from obtaining hospital credentials or perhaps even cause a hospital to revoke them?  Physician credentialing software these days must be based on an overwhelming mountain of legal fear.  One of my partners failed to disclose a minor in possession ticket  (MIP) during her teenage years.  After failing to disclose this ridiculously unimportant legal request, her hospital credentials were delayed for weeks, perhaps months in order to send letters and appear in committee meetings to explain herself

One local physician even told me that another colleague at another hospital had failed to disclose that he got a ticket for fishing without a license.  That's right folks.  A ticket for fishing. When he failed to disclose this dastardly deed on his hospital credentialing paperwork, his approval was denied and delayed. Unbelievable.

This is what the legal environment of doctors and hospital credentialing has become.  MIPs and fishing licenses.  The fear in medical credentialing is out of control.   In a new one for me, physician credentialing software asked me how many children live in my home and if I'd ever lived with any children in the past.  The title of the document I was to sign had to do with any previous allegations or arrests for child abuse or sexual assault.  Now the hospitals want to know if I have any children in my home.  What has this world come to?

With such a large volume of legal detective work being done on every physician credentialed at  every hospital, one has to wonder how is it even possible for a bad apple to fall through the cracks?  If you have a hospitalist seeing you at your hospital, you can rest assured their past has been raked through the coals and their history and credentials have been picked apart by government agencies, specialty societies and even the hospital you find yourself in and  absurdly so.

This post is for entertainment purposes only and likely contains humor only understood by those in a healthcare profession. Read at your own risk. 

Print Friendly and PDF