Why Didn't I Think of This?

What the public REALLY needs: a credentialer of the credentialers, based in Washington, DC!

These guys have it all: An Editorial Committee, an International Task Force, an External Stakeholder Development Task Force,  Public Member Development Task Force, Credentialing Careers Task Force, and Emerging Leaders Task Force - oh, and don't forget the Legal Action Fund to pay for hefty strongman tactics!

Sounds like the playbook for the American Board of Medical Specialties Maintenance of Certification (MOC) Program and the Accreditation Council for Graduate Medical Education, doesn't it?

Pure genius.

I feel so much safer now, don't you?

-Wes

Why Credentials?

Today, the ongoing turf war between nurse anesthetists and anesthesiologists was reported in the Wall Street Journal:

Gov. Arnold Schwarzenegger decided last year to allow nurse anesthetists in California to work without a supervising physician. Now two doctors’ groups are challenging the move in court, according to HealthLeaders Media.

The fight centers over 2001 Medicare rules that usually require a doctor to supervise when nurses administer anesthesia, but allow states to op out of the requirement if a governor sends a letter to the feds. California did that in June.

Needless to say, the anesthesiology community was not too happy and filed suit to block the decree.

But we must ask ourselves, where are the credentialling bodies in this debate?

On an recurring basis, doctors must obtain continuing medical education credits and pay large sums to state regulators to remain licensed to practice medicine in a state. The process involves validation of license to practice, education/training, malpractice coverage and claims history, DEA/CDS certificates, hospital privileges and whether or not the physician or healthcare professional has been sanctioned.

So when states want to replace doctors with nurse anesthetists, where are the credentialling bodies in this discussion? Don't such moves by politicians in the name of cost savings make the whole physician credentialling immaterial?

We already know that very few states legally protect the term "board certified" as having relevance to creditialling physicians, and the current efforts by a state governor to permit others not subject to similar review and standards to provide medical care makes a mockery of the entire physician credentialling process.

Hey, but at least not having to have all pay those licensing fees and education course fees would save everyone money.

-Wes

Economic Conflict-of-Interest Credentialling

Now here's a new twist to physician credentialling:

An “economic conflict-of-interest” policy imposed by Baptist Health has ignited debate that often comes down to this: Are some hospitals and doctors more concerned about their own success than what’s best for patients?

The policy, also called “economic credentialing,” denies doctors privileges at Baptist Health hospitals if they own a stake in a competing facility. The Baptist Health system, the largest in Arkansas, includes Baptist Health Medical Center in Little Rock, as well as facilities in North Little Rock, Arkadelphia, Heber Springs and elsewhere.

Boy, seems the hospital better be careful here. At least one other major medical center has a counter-suit pending by a doctor who exposed conflicts held by others in the hospital's organization. Gosh, and what about the issues of restriction of trade?

Conflicts abound on both sides. I'm not saying I have the answer in this case, but this is certainly new territory for physician credentialling...

-Wes