Friday, March 8, 2019

GAO Report Reveals VHA’s Need for Improvement in Credentialing and Hiring Process


            A report from the U.S. Government Accountability Office discovered that the Veterans Health Administration had overlooked or missed adverse actions that were reported to the National Practitioner Data Bank (NPDB) while hiring physicians and other healthcare providers. The GAO analyzed healthcare providers at the VHA as of September 2016 who were recorded in NPDB, and found that VHA facilities did not consistently act within VHA employment policies and hired providers with various disqualifying adverse actions.

Staff that were involved in the credentialing and hiring process in at least 5 facilities did not have knowledge of the VHA policy regarding hiring providers with revoked or surrendered licenses due to misconduct or incompetence. VHA officials have stated that they are developing improved processes to verify credentials of providers and ensure they meet all requirements. In December 2017, the VHA conducted a review of all licensed providers and removed 11 that did not meet the licensure requirements, but these reviews are infrequent.

 The GAO made seven recommendations on how the VHA can better their reviewing and hiring process. The recommendations included that the VHA should implement mandatory training periodically for facility staff that is responsible for verifying credentialing and hiring.

Click here for more information regarding the GAO report on VHA.

Friday, January 25, 2019

ABMS Vision for the Future Commission Releases Report on MOC Process


On December 11, 2018, the ABMS Vision for the Future Commission released a report regarding their review of the MOC process. The Commission was tasked with reviewing MOC within the current medical profession and confronted issues that ABMS Boards and Diplomats experience. The Commission addressed areas that are problematic for physicians and provided recommendations for overhauling the MOC system, including retiring the “maintenance of certification” terminology. It remains to be seen what specific changes the ABMS will make to the MOC process, but the commission’s report represents a concerted turn towards real change in the current status quo.

                The Commission also recommended that ABMS boards conduct research to analyze the success of continued certification in helping clinicians provide quality and safe care for their patients. In addition, ABMS should research potential activities that help clinicians maintain their skills. The commission did not directly address fees, yet the survey measured that 58% of doctors said MOC costs were their top concern, 52% said MOC was a burden, and 48% said MOC was not a true reflection of their abilities as clinicians. The Commission report suggested shifting from single point-in-time assessments leveraged years apart to more regular, longitudinal, multi-source assessments to provide more useful appraisals of physicians’ ongoing competence. The report also encouraged medical staff offices and other credentialing professionals not to make credentialing and privileging decisions solely on the basis of certification status, but to utilize certification as an additional data point when evaluating practitioner applicants.

Commission Co-Chairs Christopher Colenda, MD and William Scanlon, PhD told Medscape that while fee structures and pricing were not addressed in the Commission report, they noted that boards should implement reasonable fees. They believe that the changes recommended will enhance the value of the MOC process for all stakeholders. Former NAMSS Presidents, Linda Waldorf and Diane Meldi contributed to the Commission’s work.

Click here to read the Commission’s draft report and here for more information regarding the ABMS commission report on MOC. NAMSS will continue to monitor any further actions of the Commission and changes to the MOC process.

Tuesday, December 11, 2018

2018 Updates to the NPDB Guidebook


           The Health Resources and Services Administration (HRSA) recently updated its online National Practitioner Data Bank (NPDB) Guidebook on October 26, 2018. This is the first time the Guidebook has been updated since April 2015. The October 2018 Guidebook added a new section titled “Length of Restriction” under Chapter E: Reporting Adverse Clinical Privileges Actions and alters language regarding the reportability of proctoring. The Guidebook also adds seven new questions and answers to the end of Chapter E. Additionally, the Guidebook clarifies that indirect action taken by a physician during an investigation maybe reportable.

            The new section titled “Length of Restriction” states that if a restriction has an adverse effect on a practitioner’s privileges for more than 30 days, then it is reportable on the 31st day, regardless if the length of the restriction is in writing. The seven new questions that address reporting requirements address the following topics:
  1. Agreements not to exercise privileges while under an investigation (Q. 22)
  2. Leave of absence while under investigation that restricts privileges (Q.23)
  3. Reappointment application review (Q.24)
  4. Resignation while subject to a “quality improvement plan” (Q. 25)
  5. Restrictions versus generally-applicable guidelines regarding first assistants and practitioner specific requirements (Q.31)
  6. A practitioners lapse of privileges at the end of a scheduled term (Q.46)
  7. Guidelines on updating NPDB reports modified by Court order (Q.49)
Click here for more information regarding the NPDB Guidebook.  

Tuesday, September 4, 2018

Foreign Medical Graduate Commission Updates Identity Certification Process


The Educational Commission for Foreign Medical Graduates (ECFMG) recently announced an enhancement to their process for certifying the identities of applicants, beginning in mid-September 2018. The current Certification of Identification form (Form 186) will now be required to be completed online, using NotaryCom.com. NotaryCam is an online service that provides 24 hour access to professional notaries, allowing applicants to bypass the sometimes complicated and burdensome process of using a notary in person.

Additionally, the online Form 186 will now be a requirement for applicants as part of the Application for ECFMG Certification. This is required before submission of an application to take the United States Medical Licensing Examination (USMLE). All new Certification of Identity forms will require the online process, as well as expiring or invalidated forms. Currently, the Certification of Identity form lasts for five years from the accepted date. Find more details about the new process here.

The ECFMG is the standard for international medical graduates (IMGs) to be evaluated on their qualifications before entering the US graduate medical education (GME) process, or to take the USMLE and obtain a license to practice medicine in the US. ECFMG also provides application, visa, and verification assistance for IMGs. Learn more about the ECFMG at https://www.ecfmg.org/

Wednesday, August 29, 2018

NAMSS Releases Position Statement on MOC


Maintenance of Certification (MOC), the program through which ongoing physician competence is demonstrated through American Board of Medical Specialties (ABMS) and American Osteopathic Association (AOA) boards, has been controversial since its launch. As NAMSS members have heard, the ABMS has recently launched an initiative to reexamine MOC and provide recommendations for the future state of physician certification. NAMSS has engaged with this Vision Commission, with several NAMSS leaders participating in past meetings, and with other organizations to contribute the MSP perspective on this issue. As the issue has continued to affect MSPs directly and indirectly, NAMSS has released the following organizational statement on Maintenance of Certification.

The National Association Medical Staff Services (NAMSS) supports efforts by the American Board of Medical Specialties (ABMS) and stakeholders across the health care industry to re-envision the process of continuing board certification and the Maintenance of Certification programs. Demonstrating ongoing physician competence is an essential piece of maintaining patient safety, and is an important part of evaluating practitioners for credentialing and privileging decisions. Concerns around the existing continuing certification programs have led some states to propose or enact laws restricting their use in making these decisions, which infringes on the ability of Medical Services Professionals and Organized Medical Staffs to fulfill their duty in evaluating providers. However, physician burnout is an increasingly difficult issue as additional burdens are being placed on providers across the continuum of care.

Increased standardization, clarity of requirements, and reduced physician burden will all be integral parts of a modern, effective board certification program. NAMSS looks forward to the outcomes of the ABMS’ Vision for the Future Commission and to aiding in the evolution of board certification to best support our ultimate goal of patient safety.

NAMSS will continue to monitor the work of the ABMS Commission and other progress in the area of continuing physician education, and work to inform our MSPs about important developments. Find our position statement and others at the NAMSS website, and be on the lookout for further communications on this issue.

Thursday, July 26, 2018

AMA Releases New Resource on Addressing Disruptive Physician Behavior

As MSPs, maintaining an organized, productive staff office is an essential part of the job. Disruptive behavior by physicians can pose a threat to the functioning of your hospital, and dealing with instances of such behavior is a struggle for anyone working around it. Dealing with disruption in the workplace can be confusing, and it is important to be prepared if you encounter it in your hospital.

The American Medical Association (AMA) has recently released a free learning course addressing this topic. This 30-minute module will show you how to define appropriate, inappropriate, and disruptive behavior and present guidelines for dealing with these behaviors. Additionally, you will receive your own downloadable copy of the AMA Model Medical Staff Code of Conduct that you can integrate into your own medical staff bylaws.

You can access the module here. The course is designed for physicians and hospital administrators as well as medical staff, so please feel free to share within your facility.

Thursday, June 21, 2018

How the Leadership Certificate Program Helped Meredith Land a New Job

The NAMSS Leadership Certificate Program can have a great impact on you and your career path. Read how Meredith Miller used the program to gain the confidence she needed to land the job she wanted. 

Did the Leadership Certificate Program help you gain any new skills, or help increase your confidence as a leader?
I absolutely gained new skills and confidence from the Leadership Certificate Program. I felt that the online modules were a great learning tool and the extra resources provided were a bonus. As a Credentialing Specialist, and not a manager, this program was extremely helpful in learning new skills, and I was able to gain a wealth of knowledge from both the online modules and the in-person course. I really feel as if I now have more effective communication skills, even in my personal life, which has greatly increased confidence in myself. 

How are you using what you learned from the Leadership Certificate Program in your current role?
Just prior to attending the in-person course, I resigned from a hospital that I had been working as a Credentialing Specialist for 14 years, with the past 12 having been offsite working from home. I decided at the beginning of January that I wanted to go back into the office setting and work closer to where I live. I applied for a Credentialing Coordinator position and was offered the job the day after the interview. During the hiring process, I was able to use the effective negotiating skills and communication techniques that I learned from the Leadership Certificate Program. I felt that my communication, calmness, and confidence during the interview process was very effective and I can say that the gained knowledge I attained from the program played a role in getting the job.

What aspect of the program did you enjoy most?
I immensely enjoyed the In-Person Course -- the instructors were fantastic and made everyone feel relaxed and at ease in being ourselves. It was fun working in teams and interact with other professionals that held different positions from mine. I ended up working with three managers in my group and it was very interesting to see their different management and leadership styles.

Would you recommend the Leadership Certificate Program to your peers?
I would absolutely recommend the Leadership Certificate Program to my peers and have already done so! In my opinion, the online modules are a wealth of useful information for both experienced and entry-level MSPs. The program helped me look at things from a different perspective in terms of communicating with others in a professional setting. I think the In-Person Course really allows you to apply what was learned during the online portion, and the live group scenarios was a confidence builder. Overall, I felt it was a very effective course and will continue to recommend it to others!


Visit the NAMSS website to learn more about the Leadership Certificate Program.