QUESTION:      Our state, probably like most, requires a criminal background check. Our employed physician group has hired a badly needed primary care physician to serve in one of our more rural clinics. When his application was submitted for medical staff appointment, the report of the background check stopped the process cold. It listed arrest for “minor” infractions, such as assault and disorderly conduct.

The employer insists that the physician’s application be processed timely, as he was scheduled to start in the clinic on January 1. The medical staff process requires that we follow up on unusual information in an application. The applicant is claiming that the hospital is “interfering with his contractual relationship.” This has exacerbated the rift between HR and the medical staff. I thought we were all on the same team? What now?

ANSWER:     With notable exceptions to be sure, the HR/medical staff disconnect, when it comes to employed physicians, has been more perplexing than it needs to be. Medical staff professionals and physician leadership are increasingly very well trained credentialers. They “get it” that credentialing is a duty owed to the patient – to assure that those who are selected to practice in the organization are well qualified to do so safely and competently. They know how to follow up on unusual or problematic questions, circumstances or blanks in an applicant’s background. Their mantra is “the burden is always on the applicant” to demonstrate that he or she qualifies.

Issues such as yours require follow-up, to determine if the arrest was the result of one awful and regretted event or a manifestation of a larger problem.   In addition to the duty to the patient, the medical staff and leadership know very well that there is also a duty to treat the applicant fairly. In this case, that might involve requiring the applicant to provide a complete explanation and documentation of the incident for further assessment.

Some employers of physicians have not caught up to this duty and process. They often have different objectives, such as making sure the clinic is staffed timely.

This is an easy fix, except when you are in the middle of it. The necessary process is that the recruiters, those who hire in the employed physician group and HR must have access to the same excellent education your medical staff professionals have. The “threshold qualifications” for employment and appointment must be coordinated. The employed physician group and HR may create a structure, whether a CVO or some other contractual relationship, to employ the expertise of the Medical Staff Office in the assessment of applicants.

Employment itself never qualifies a physician for medical staff appointment or clinical privileges. Ever.