Malpractice suits: Getting down to brass tacks
References to red flags are rife in the medical staff arena. Loss of licensure, significant malpractice activity, poor clinical references, and their ilk are targets of considerable scrutiny during the credentialing process. But what about the subtler inconsistencies and deviations that can surface on a medical staff application? License disciplinary action, a smattering of malpractice claims, and lukewarm references are likelier to fly under the radar than their glaring counterparts. In today’s quick tip, Carol Cairns, CPMSM, CPCS, advisory consultant with The Greeley Company and president of PRO-CON, an Illinois-based medical staff services consulting group, shares advice for addressing one such pink flag before it turns scarlet.
Q: Our medical staff application requires applicants to explain any pending or closed malpractice suits. We currently have an applicant who has a malpractice suit pending yet has stated that he has been advised by his attorney not to discuss the case. What should we do?
A: I’ve heard this response in my history periodically, and the answer is: The burden is on the applicant. We understand that attorneys can be concerned about giving information on an active malpractice suit, but the basic principle here is, privileges are a privilege—privileges are not a right. Physicians, physician assistants, nurse practitioners, etc., do not have a right to medical staff membership and privileges.
The medical staff’s bylaws and policies should specify that applicants must submit a completed application. In the instance of a pending malpractice case, the applicant is requested to identify the suit and its status. Thereafter, the information received would be compared to information obtained from the malpractice carrier.
When an applicant falls short of these requirements, respond to him or her in a professional manner. Say something to the effect of, “This information needs to be provided; if it’s not provided, your application is considered incomplete, and we won’t be able to process it further.” Generally, that notice motivates the individual to move forward and supply the necessary materials. If the notification does not have this effect, then you have to do what you said: Consider the application incomplete.
The confidentiality of most credentialing processes is protected in states’ peer review statutes. Some states have greater protections than others, but in general, most credentialing processes are protected. If they’re not, an organization wouldn’t want a plaintiff’s attorney to get to that information and see that the medical staff did not follow up on a pending case for which the doctor refused to provide details.
Source: Medical Staff Applications: Pink Flags Versus Red Flags (available on demand)