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Medical Last Updated: Feb 25, 2008 - 12:25:17 PM


There's a Question About the Credentials of Nearly 9% of Medical Practitioners
By CPR Strategic Communications
Feb 25, 2008 - 12:22:15 PM

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Results of a study examining the credentials of 9,597 physicians, nurses and ancillary personnel practicing in 24 healthcare organizations including hospitals, surgery centers and health plans, show nearly nine (9) percent of the defined group were practicing with one or more of 52 questionable issues regarding their credentials. Medversant Technologies LLC, the leading provider of Web-based healthcare practitioner management applications and study sponsor, made public this week its Adverse Actions report, reflecting the above findings spanning a 10-month period from January-November 2007 and representing healthcare organizations primarily in CA, TX, LA, TN, KY, and IL.

These findings are alarming and significant when hospital administrators and health leaders extrapolate the results throughout their participating physician and professional rosters, says Matthew Haddad, CEO of Medversant. There are potentially millions of medical professionals and health care staffers out there who are who do not have a valid license or are practicing with questionable credentials. These individuals are dispensing care to hundreds of millions of patients nationwide, compromising patient safety and the integrity of healthcare in our country.

Study Methodologies:

The study reviewed professional licensing of 24 healthcare organizations using Medversant s OneSource technology, which provides continuous Web-based technology to monitor the licenses and background information of physicians, nurses, therapists, and other medical providers. OneSource is an automated process that taps all major databases in real time including state license boards, Drug Enforcement Administration (DEA), National Technical Information Service (NTIS) and the Excluded Providers Listing Service (EPLS).

Key Findings on Physician Credentialing:

Total number of physicians (MD/DO): 7,318

829 or 11.33 percent identified as practicing with questionable issues.

  • 99 or 1.35 percent - no license found, surrendered license, suspended license, inactive license, terminated license due to federal/state sanctions
  • 419 or 5.72 percent expired license
  • 311 or 4.25 percent - public reprimand, lapsed license, malpractice claim payment, restricted license, probation, loss of privileges, state board sanction, board order

According to Haddad, most medical facilities update practitioner credentials only once every two or three years, a practice that can allow for improperly credentialed professionals to go undetected for long periods of time.

In fact, Medversant recently issued a health alert to the industry following a Medicare investigation that uncovered the fact that numerous fraudulent medical professionals were working in hospitals, nursing homes, and other healthcare facilities, says Haddad. This fact poses a serious threat to patient care and can also negatively impact reimbursement for services sending a dismal reality check for hospital and health care administrators. Furthermore, when unlicensed providers deliver care with less than optimal outcomes, the potential for expensive litigation is very significant.

Citing the need for objectivity as well as speed in verifying credentials, Haddad also points to a recent survey conducted by the Institute on Medicine as a Profession. Published in the online edition of Modern Physician (12/03/07), the report shows that nearly half of the 1,662 primary-care and specialty physicians questioned said they did not always report incompetent colleagues (45 percent) or medical errors (46 percent) when these came to their attention.

There is clearly a need for objective, reliable and impartial reviews of physician credentials, says Haddad. This need extends to all aspects of the enterprise as health care organizations strive to operate with the confidence that they are offering the highest quality care and safety to their patients. The current approach which involves intermittent and paper-based credentialing is falling short of market expectations for excellence and exacerbating the widespread perception that our health care system is compromised by outdated administrative processes and worse, that is down right unsafe.



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There's a Question About the Credentials of Nearly 9% of Medical Practitioners