By Michael J. Baron, MD, MPH, FASAM
Every few weeks we receive a phone call asking for help — not with substance use, addiction, or a mental or behavioral health problem, our usual areas of assistance. Instead, these calls are more related to sins of omission: demographic, professional, health, or other personal information on an initial or renewal license application, hospital privilege or insurance panel credential form was omitted, not verified, not updated – or a deadline was completely missed.
Unfortunately, this happens with regularity, and the consequences can be serious.
Physicians and other health professionals spend years training to be able to do what they do and do it well. Because of this, the profession has a high degree of public trust. They are obsessive and perfectionistic: they will check and recheck a lab value, review an x-ray themselves even when they have the radiologist’s report, spend hours at night writing, editing, and signing progress notes. Even with all this perfectionism on behalf of their patients, they are often lax in their own personal data and their own health (a different topic). They frequently fail to check professional paperwork for errors, renew their medical license on time, or make sure that their profiles on hospital and regulatory websites are accurate. I am amazed at some of the stories we hear and horrified by the consequences that happen as a result of not keeping their own data updated.
When a physician signs their name at the bottom of a hospital privilege, insurance panel, medical license application or other form, they are solely responsible for the content. It is imperative that the information in any signed application or document be true and accurate. Many times, a practice manager or other administrative staff will fill out the application or form for a recent physician hire, which can be helpful since the paperwork can be dense and time-consuming. There are potentially embarrassing questions on some professional applications and to avoid feeling shame at having to answer “yes,” physicians will sometimes – consciously or subconsciously – allow someone else to fill out the form instead. Unfortunately, that person may not know the facts or details surrounding the yes answer or even know there is a yes answer. By default, the practice manager checks no to all the pertinent questions — they are usually not being dishonest or trying to protect the physician, they are just not informed. Sometimes, there is intentional dishonesty: recently, a health professional wanted their background hidden from a health regulatory board, so they willfully checked no to a licensure application question when the honest and correct answer was yes. In this case, the consequences were dire. If they had checked yes, it would have been much easier and less expensive for the applicant. The cover-up is always worse than the crime.
We received a phone call from an out-of-state OB/GYN who has been the subject of two malpractice lawsuits. Her history also includes being in recovery for over 10 years from an alcohol use disorder, and being monitored by her state’s Physician Health Program. She was hired by a group in East Tennessee contingent on being granted a Tennessee medical license, and the group’s office manager filled out her license application on her behalf. The physician had disclosed her recovery and two lawsuits to the group’s managing partner but not to the office manager, so none of that information made it into the application. The Board of Medical Examiners (BME) learned about the lawsuits from the National Practitioner Databank. The physician was invited for an interview with the Board and was accused of fraud for not disclosing the lawsuits. She ended up disclosing not only her malpractice history but her addiction and recovery history as well, which would have remained confidential had she made sure her application was accurate.
Another physician was referred to us for disruptive behavior about a year after joining a new practice. As part of our “new identification” process, we verify licensure information through the BME website and discovered his medical license had expired five months earlier. The reason: the manager at his old practice handled license renewals so this was dropped when he left. This physician was practicing on an expired license, which is the same as practicing medicine without a license. This lapse cost him a great deal of money in legal fees, fines, and lost productivity – it took another three months to reactivate his medical license before he could go back to work.
CHECK AND DOUBLE-CHECK
There are multiple cases brought to our attention caused by outdated, incomplete, or falsified information provided to license applications, hospital privilege forms, insurance panel forms, or even in social media. Physician information will get posted online by various entities so if it is wrong on the application, it will be wrong online.
It is crucial for health professionals to check and double-check the information published about them in print and on websites. Look for this information on hospital provider lists, insurance provider panels, physician or group practice websites, state licensing websites, and on your personal online profiles. Search your name and medical license on the Internet to ensure you are checking everything about your practice or professional history that is available online. When information changes, such as board certification, a practice address or a phone number, those changes need to be communicated to these organizations and their websites.
Inaccurate, outdated, or false information can be viewed by health regulatory boards as unprofessional, unethical, or dishonorable behavior, which can lead to an action on your medical license.
In summary, please check your demographic, professional, and personal data on all initial and renewal license applications, hospital privilege, and insurance panel credential forms for accuracy as thoroughly as you check your patient’s data before signing. Make sure that any history or “yes” questions are correct, and add an explanation if required or requested. This will help to keep you out of harm’s way.
Share your thoughts with Dr. Baron at firstname.lastname@example.org.