Prepare a reference letter when an employed physician leaves
When an employed physician leaves a hospital, a credentialing best practice is that the “next” hospital asks both the medical staff services department (MSSD) and the HR department for a reference. Why? Unfortunately, there are occasions when a hospital will terminate the employment of a physician and the MSSD knows nothing about it. It is important to remember that one day you might be the one requesting a professional reference from another organization and expecting factual information on a physician so that you can make an informed recommendation about privileges.
Best practice warrants that whenever a physician leaves, employed or not, the factual circumstances of that medical staff resignation be captured in real time in the form of a “forever letter” that goes into the physician’s credentials file and can be used for future requests for professional reference from another organization. It could be as simple as stating that the physician left in good standing to take an opportunity in another state, or it might be tricky because there were concerns that did not rise to the level of an investigation, privilege restriction, or adverse action. Each organization has to determine ethically and with advice of counsel how and what will be shared.
Looming in the background of such considerations is the “Kadlec Case,” in which one hospital (Kadlec Medical Center, Washington) sued another hospital and a physician group for failing to provide information concerning substance abuse problems with an anesthesiologist who had applied to the staff at Kadlec. The ruling is a bit ambiguous in that the judgment was upheld against the medical group for providing a positive reference but dropped against the other hospital because it provided a neutral say-nothing reference. But certainly expect to see more cases like this in the future. The key takeaway from Kadlec is that even though the physician was not employed by the hospital, the established practice is to require a reference from both the medical staff where a physician holds privileges and from the actual employer. In the case of hospital-employed physicians, that means two letters: one to the MSSD and one to HR.