Chat with us, powered by LiveChat

Medical Justice

Making healthcare safe for doctors


Healthcare Reform

Credentialing and Answering Touchy Questions

05/06/16 4:20 PM

I received a call from a general surgeon in California. He was re-credentialing for hospital privileges. He was re-credentialing for his in-network status with insurance companies. And, renewing his medical license was around the corner.

Credentialing questions have gotten longer and more detailed.

In his case, the surgeon was concerned about questions asking about his general health. During a routine physical exam, a worrisome incidental finding was noted. This led to a two week odyssey of more extensive tests. Lots of worrying. Lots of pages added to his medical record. But, his treating physician concluded all was clear. No worries. No change in longevity. No change in function. Carry on.

The surgeon did not want his medical record pasted to the re-credentialing forms. He reasonably believed that it would be difficult to keep such information confidential. He was concerned his records would leak. And it would create more questions. Rumor. Innuendo. And his booming practice would collapse.

So, how should such questions about personal health be answered?

It depends upon the questions.

At one time, licensing applications asked broadly about health. Those questions collided with protections offered by the American with Disabilities Act. So now, the questions have become more tailored. For illustration, take a look at one question from the renewal application for medical licensure in North Carolina.

Since you last renewed have you become aware of any medical condition that impairs or limits, or could possibly impair or limit, your ability to practice medicine safely? (If you are an anonymous participant in the NC Physician Health Program and in compliance with your contract, you do not need to list any medical conditions related to that contract).

Medical Condition includes physiologic, psychiatric, or psychologic conditions or disorders including, but not limited to, orthopedic, ophthalmologic, or neuromuscular problems, speech or hearing impairment, or infectious disease.

Do not use abbreviations in your response

In answering credentialing and licensure questions, you do not want to be accused of failing to disclose. You do not want to hide information. If found out, your deception will lead to loss of privileges and/or licensure.

But, note the plain language of the question. The Medical Board is NOT asking you to paste your medical record to the application. They are asking whether you have a condition that could impair your ability to practice medicine safely.

That is not an unreasonable question.

If you are a neurosurgeon and you have medication-resistant epilepsy and no way to predict when your next seizure will occur, the answer is “Yes.”

If you are a cardiac surgeon and you are being treated for melanoma and your chemotherapy regimen has minimal side effects, the answer is “No.”

If you want to dot your i’s and cross your t’s, ask your own treating doctor whether he/she believes your newly diagnosed condition might impair your ability to practice your specialty safely. Have your doctor either place it in your medical record, or provide you such a document. Regardless, if ever questioned down the road, you will have a record that your conclusion is more than just your opinion. It is shared by the person who knows all about your medical history and knows a thing or two about what it means to practice medicine safely.

Now, go practice in health.

Posted by Medical Justice | in Healthcare Reform | 3 Comments »
newest oldest
Notify of
Michael M. Rosenblatt, DPM
Guest
Michael M. Rosenblatt, DPM

While I appreciate the necessity of disclosing and considering the physical and mental health of a doctor who is renewing and re credentialing, ultimately the decision of whether the doctor can still practice is often just an “opinion” of a Medical Board member, or worse, a functionary of an insurance company who is neither a physician nor even an educated participant. If the functionary of the insurance panel is looking to reduce the number of specific specialists on their panel (always to reduce costs), your name may come up for “convenience” purposes, say if you disclosed a disorder that was… Read more »

Anon
Guest
Anon

I’m not sure how long this will last, but to protect my privacy, I request physicians caring for me to keep a paper, not an electronic health record – except for my yearly ophthalmology exam. I’m planning on practicing till I’m dead, or unable to work, and anything but checking the “no medical problems” box will raise red flags. The medical boards are certainly trying to put a shelf life on our time practicing medicine. One of the residents I trained with had an epileptic seizure before commencing a procedure on one of our chairman’s patients. When DrL walked into… Read more »

Pamela A. Pappas MD
Guest

In response to the article, and also to Michael M. Rosenblatt DPM above: I agree that things have changed for physicians going through credentialing and licensure in recent years, especially in the psychiatric arena. Yet we have an epidemic of suicide (over 400 physicians/year), disillusionment, and burnout in physicians today. The suicide numbers have not changed in the over 30 years I’ve been in practice. People need help — and are not getting it for precisely the reasons Dr. Rosenblatt describes. Of course there are others too, but most of the hundreds of medical students, residents, and practicing physicians I’ve… Read more »