The origins of credentialing

Contemporary credentialing practices can be traced back to the early 20th century, when healthcare leaders were anxious to earn public confidence in modern hospitals. In previous centuries, hospitals had functioned primarily as the last stop before death. In the late 1800s and early 1900s, dramatic advances in antiseptic practices, anesthesia, surgical technique, medical procedures, and laboratory testing moved healthcare forward by leaps and bounds.

But even as this stunning progress transformed hospitals into places of hope and recovery, medical training floundered. Practitioners were trained in a wide variety of settings sans common educational curricula and requirements. Consequently, many were poorly prepared to wield the increasingly effective tools of modern medicine. Nevertheless, as hospitals grew in standing as venues for treatment, it became increasingly important for clinicians to gain access to the “doctors’ workshop,” a moniker deriving from the hospital’s emerging reputation as a one-stop shop for the resources necessary to facilitate the practice of modern medicine, including the following:

• Technical tools (e.g., laboratories and radiology suites)
• Facilities (e.g., operating rooms)
• Staff (e.g., surgical nurses, anesthesiologists, pathologists, and lab techs)
• Beds for prolonged recoveries after surgery and treatments

By the middle of the 20th century, few physicians could establish a clinical practice without a hospital affiliation.

The advances in medicine created a new breed of physicians who championed the standardization of practice. They argued for rigorous procedures to ensure that practitioners were qualified for their work.

Editor’s note: This is an excerpt from Negligent Credentialing: Strategies for Reducing Hospital Risk. Platinum Plus members can read the e-book for free here.