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I have wanted to write this segment for awhile, and have been putting it off. I don’t really know how to approach this topic without my personal feelings coming in to the mix. But I am a person.
As a Credentialer, I didn’t make the big decisions. I brought the facts of a physician I found to others (that made more money than I) to make the hard choices. I was grateful for it. If it was the wrong choice I would feel less guilty, but amazingly enough that was never that case. I always felt there was more I should have done. If I had only done this, or maybe checked that again, the outcome would have been different. I should have felt better knowing that the blame would not rest at my feet but it never helped. I have always felt there was something more I could have done.
What if you did all you could but the information you received was a lie? Would that make it easier? Would I feel less guilty? If I had dug deeper, not trusted the verifications I’d received? Maybe if I asked three times for the truth, they would have given it to me. What about those people who told you the lie? The Physicians who wrote you “Glowing letters of Reference” for a Provider they fired because of a Drug Problem. What happened to “Do no harm” does that only apply to your direct patients? What about the Hospital; that thought I would see a GIANT RED FLAG when they replied to my Verification letter with an form letter that stated “Due to the volume of our requests”…?
I have Credentialed hundreds of Physicians, and for every two of them I received a letter that started “Due to the volume of our requests”. Am I the only one who didn’t know this was a red flag until the Kadlec case? I thought they were just being lazy. (To be fair, one person for every thousand letters is not lazy, it’s over worked) Someone actually thought this letter up, such a fast way to dispense the verification requests. The funniest thing is, if you dare send the same letter to a place that ‘SENT’ you one of these, they get huffy. “It’s against our bylaws” or “we have certain standards”
What happens when the powers that be decide to let it be someone else’s problem? They took a big gamble and everybody lost. A Doctor lost a license. A hospital and two Physicians’ reputations have been tarnished if not ruined and all of them have all been sued millions of dollars. But more importantly a woman lost her life. A family lost their mother.
It’s the court case of the century.
Before it was a court case, it was a lie! I wonder if the physicians thought ‘it’s a small lie, he’ll be fine’ or the hospital just figured they didn’t have to say anything because ‘he just doesn’t work here anymore’.
Were they hoping that one another would say something they themselves were to spineless to say? Or did they work together to market this lie, to get him away from their loved ones, to make it someone else’s problem?
I don’t know.
Let me know what you think
Ronda
Time Gaps
My rule of thumb is “anytime that a person can spend in prison” is a time gap. 30 days is my general ‘must know’ rule; but I know that some states need to have an accounting of ALL time from College to present.
This gets tricky,
14 Days? Could be a vacation.
21 Days? Family Emergency.
30 days? I always go to ‘Were they in jail? Where have they been?’
30 days is how long they could have been suspended from the hospital. And if they were, why were they suspended. I hear my mothers voice in my head, when I had done something wrong. “WHAT DID YOU DO?” It always stopped me cold, even if I didn’t do anything wrong. Now it’s all I hear when I find any gaps for 30 days or more.
Ronda
Vague curriculum vitae (CV) Time lines that could mean anything.
For example, CV states residency years 1978 – 1981. I personally hate CV’s that only have years. This is misleading; the provider could have started Residency training in December of 1978, and finished January 1981. Not only is the provider off track but clearly short of training.
This runs true with work experience as well. Even if the Physician gives months and years there is still lots of time that would be unaccounted for.
Ronda
Physician did not take an ABMS/AOA Board Certification Exam
Like everything else in credentialing there is at least 2 exceptions to every rule.
Exceptions like
- How old is the Physician, older Physicians might not have thought board certification was worth it.
- Did the ABMS/AOA even have an exam for that specialty when the provider was in training?
If you have a Physician that has completed training starting in the 1990’s they should be board certified in something. My take on this is that Board certified providers will have an advantage over older, non-board certified physicians in respect that it will them more money.
Why would you spend 8 years in College at least 3 years in Residency not to make as much money as you possibly could? (I know that money is not the only reason for someone to get board certified but I am very cynical)
I had a Physician, (we will call him/her Dr. DuMass) tell me that the reason they did not complete a Board Certification exam was that he had some financial problems and needed to start working right away.
Dr. DuMass had completed his training in 1991, and this was the year 2000. I had only been working as a credentialier to this point for only six months. I was still a little timid about how much concern I should give this seemingly small issue. I brought it up to the powers-that-be, but didn’t think about it until I received a verification letter that stated he had been kicked out of his residency program. That was the reason he didn’t sit for the boards.
I was much louder about my concerns after that.
Licensing Exam – Taken more than once or took longer than 7 years to complete all steps
I am only going to brush on this one. I will go into more detail into the different Licensing exams there are later.
Were looking at how many times a Physician took an exam not what exam they took. If a physician step more than once, or how long it took between steps. Different states have rules on how many times a physician can take an exam, and how much time has elapsed from the first exam to the final exam.
Took more than 3 tries on each step or they took longer than 7 years to complete all the Licensing exams.
– It could be that the Physician is a bad test taker.
– It could be their not a very good Physician
Failing a Step or Level of a licensing exam can cause havoc with time lines for graduating Medical School or finishing Residency.
