Doctors fight tooth and nail to avoid being reported to the National Practitioner Data Bank (NPDB). With good reason. If you want to apply for a new job, a new medical license, new hospital privileges, new network status with insurance carriers, or new coverage with a professional liability carrier, a stain on your otherwise clean record may make it harder or practically impossible to succeed.
It’s also a challenge with renewing all of the above.
If you leave a job, how you leave may determine whether your plain vanilla NPDB report will soon have a smudge.
Some doctors are employed by healthcare systems. They get a W2 paycheck each month. This healthcare system also has a hospital. That hospital may be closed staff. Meaning, you have to be a W2 employee of the healthcare system to obtain and keep clinical privileges at the hospital. In this example, if you cease to be employed by the healthcare system, your clinical privileges will automatically be terminated.
Let’s say you and your boss no longer get along. In this example, you were alleged to have yelled at a speech therapist. They alleged you were unprofessional. This is the second such incident.
The healthcare system wants you to leave.
The hospital is posturing it will open an investigation. If they conclude you are disruptive, they may curtail or revoke your clinical privileges. If you your clinical privileges are restricted or lost (for > 30 days) as a result of an investigation of your clinical competence or professional behavior, that WILL be reportable to the NPDB.
But what if you are just fired? What if your employment status is terminated, and your clinical privileges are automatically terminated as a result of that employment termination? No due process. Just an algorithm showing you the door. Is the loss of clinical privileges reportable to the NPDB?
Generally, not.
Here’s a Q/A posted by the NPDB:
A hospital filed a report with the NPDB announcing the revocation of a practitioner’s clinical privileges. The reporting hospital had established a system of professional review under its bylaws, and it also had an employment termination procedure. In this case, the hospital used the employment termination procedure, not the professional review process. The practitioner’s privileges were revoked by the employment termination process, but no action was taken through the professional review process. The practitioner was not given a choice of which process (system of professional review or employment termination procedure) the hospital would use. Should the hospital have filed the report with the NPDB?
No. The termination was not a result of a professional review action and, therefore, was not reportable. It does not matter that the employment termination, which was a result of the hospital’s employment termination process, automatically resulted in the end of the practitioner’s clinical privileges. However, if the hospital had performed a professional review of the practitioner’s clinical privileges and revoked the practitioner’s privileges as a result of the review, the professional review action would have been reportable, even if the action started as an employment termination. In order to be reportable to the NPDB, adverse actions must be the result of professional review. Generally, the reporting entity decides when a professional review has occurred.
If it is clear you will soon be asked to exit, if possible, it’s a good idea to structure that departure more as an employment action (ideally, via mutual agreement) than as the hospital revoking your clinical privileges as a result of an investigation into your clinical competence or professional behavior. Also, if you resign or restrict your privileges or fail to advance your renewal application while in the middle of such an investigation, that is immediately reportable to the NPDB. There’s no 30 day “grace period.”
So, be cautious about leaving in a huff. There are better ways to leave an institution than others. Particularly if you want to maintain your otherwise boring, unremarkable NPDB report.
What do you think?
In terms of your future career, being fired from a hospital without a NPDB report, may be better on the one hand, but on the the other hand, will it make any difference for a future employer? Most likely in either event you are screwed. Why? No matter how an applicant spins their departure from a prior employer, a reference check will be conducted. It is rare that a prior employer says thinks about a departed employee.
Even if this is part of a contracted process, where there is a losing group, that must leave the hospital, at the end of the contract, (even when there was no contract — one cannot remain, because one’s privileges will be meaningless — one will not be able to exercise them), the hospital CEO can still badmouth the physician to future employers.
The bottom line is whatever the means of departure, unless it is purely voluntary, and one leaves on good terms ( a rare set of events), whether one leaves by professional action by the hospital, or because the contract is over, your career is going to take a very bumpy financially under compensated pathway.