Dealing With Dishonest Re-Applicants

QUESTION:        Late last year, we stopped processing the Medical Staff application of a physician who omitted an out-of-the-country residency training program that was begun but not completed from his application form. We considered the applicant’s explanation for the omission and determined that it was not credible. So, we chose not to process the application, pursuant to our Bylaws language that says that applications which include material misrepresentations or omissions may not be processed. The applicant was notified.

Last week, this same physician submitted a new application, this time listing the previously-omitted residency on the form. Do we have to process the application?

ANSWER:        Hospital and medical staff leaders are placed in a difficult position when an applicant who has previously lied to them seeks reconsideration. Luckily, there are a couple of ways to deal with a re-applicant who has a history of material misrepresentations or omissions.

One option is to adopt language in your Medical Staff Bylaws or Credentials Policy stating that an individual who has previously had an application for appointment or privileges deemed ineligible for processing due to a material misrepresentation or omission is ineligible to apply or, alternatively, is ineligible to apply for some specified period of time (such as three or five years). With such language in hand, you need not engage in verifying or processing any re-applications by an individual who has previously filed an application with a material misstatement or omission.

In the absence of such Bylaws or policy language, you still need not process the application as if nothing happened. Rather, we recommend that you deem the application incomplete due to the unresolved concern involving the veracity of the applicant. You can then rely on your Bylaws (or Credentials Policy) language stating that incomplete applications will not be processed and that applicants have the burden of completing their applications.

In the case of an applicant who has made a misstatement or material omission on a previous application, you should notify the individual that the application remains incomplete due to the unresolved concerns over the individual’s veracity – and then inform the individual of the deadline for submitting sufficient information to resolve that concern (for example, information showing that the individual has taken steps to address his or her lack of veracity).

It can be difficult for an individual who has lied on a previous occasion to resolve the concern that they will lie again in the future. After all, how would the hospital and medical staff leadership know whether the individual is being honest, except by being constantly vigilant in verifying every little fact that the applicant asserts? The re?applicant may choose to submit evidence indicating that the previous misrepresentations or omissions were related to an addiction problem that caused him or her to lie – and that he or she is now in treatment. Perhaps the re-applicant could show that he or she attended a professional ethics class or started filling out applications personally instead of relying on his or her office staff to do so. If the re-applicant submits any such information – and if the leadership truly believes that the information resolves the concern that the individual will lie again – then it may choose to process the application. If not, the applicant can be informed that the information is insufficient and the application will remain incomplete until such time as additional information deemed sufficient by the leadership is received.

Of course, most Medical Staff Bylaws and Credentials Policies include language stating that if an incomplete application is not completed within 30 days of notice being provided to the applicant, then the application will be deemed withdrawn. So, if the re-applicant is not able to resolve the concerns with his or her veracity during that time period, the application can be deemed withdrawn, the re-applicant can be notified, and all processing can stop.

Want to learn more about addressing applicants – and re-applicants – with red flags in their applications? Join us this fall for The Credentialing Clinic, October 15-17, in Las Vegas. More information.