July 6, 2017

QUESTION:        We have received an application from a physician and some issues have been raised.  While the physician has excellent education and training, she has moved around quite a bit and hasn’t been able to explain the moves in a way that makes sense.  She also answered “No” to the question on the application that asked “Have you ever withdrawn your application for appointment before a hospital made a decision?”  We have learned that she withdrew an application from the last hospital where she applied to practice.

Our bylaws expressly state that a misrepresentation, misstatement or omission “shall constitute cause for automatic and immediate rejection of the application resulting in denial of appointment and clinical privileges.”  Based on this language, the Chairperson of the Credentials Committee thinks we should deny her application.  What do we do?

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ANSWER:            When there are concerns about an applicant there is almost always a better option than “denial.”  A denial of an application triggers a right, in the applicant, to the hearing and appeal process, a process that is time-consuming, contentious and expensive.  And if the recommendation for denial is upheld by the Board, it is reportable to the National Practitioner Data Bank and the State Board of Medicine.

Before the Credentials Committee recommends denial, it should explore, in detail, any and all issues that have been identified.  Remember, the burden should be kept on the applicant to resolve all questions and concerns.  This means that the applicant should be required to explain the misrepresentation about never having withdrawn an application.  You can also require the applicant to provide documentation pertaining to the withdrawal of the application.

And remember to call the individuals who have provided peer references, even if there are no red flags in their response.  People will often provide information over the phone that they will not put in writing.

The Credentials Committee should hold off taking any action on this application.  Continue to gather information from the applicant and from others and keep the burden on the applicant.

And when you get a chance, revise your bylaws!  The bylaws should give you an option administratively to stop processing an application when there is a misrepresentation or omission.