This hospital medicine podcast is going to deal with credentialing, and remember why this process

exists in the first place. Credentials is the first step in protecting patients. Appointing

excellent doctors is the initial quality action taken at a health care facility. The hospital and its physicians need to trust that patients will be

well cared for under the guidance of the applying provider. Other considerations are protecting

the organization and setting up the hospital for success, and sometimes it is necessary to protect the practitioner from themselves

if they desire to do something more than their scope of practice and training.

In the most extreme cases when a credentialing committee does not do their job well,

it can even result in murder. The horrifying consequences

of the serial killer Dr. Michael Swengo was in large part due to a major failure in credentialing

at multiple hospitals he worked at. Mistakes in credentialing happen for two major reasons.

There's factual errors provided by the applicants and then decision errors by the credentialing committee.

The risk of making a bad decision rises when the essential due diligence is not completed.

We can't just rely solely on references supplied by the applicant.

Applicants cherry-pick their peer references.

An absence of unfavorable information should not be the bar we strive for.

Attempting to find omitted information is responsibility of both the organization's medical

staff services and the physicians who are overseeing the granting of privileges. A comprehensive

process is needed to verify information. For example, failing to query the National Practitioner Data Bank at the time of appointment

and every reappointment is a failure in process.

One of the first questions the Credentialing Committee must assess is competency in the field the applicant is applying for.

How is your performance regarding the privileges you are requesting?

Past performance often predicts future performance.

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