How hospitals can avoid physician impostors

It doesn't happen often, but when it does, it makes headlines and puts patients at unnecessary risk: phony physicians treating patients as if they have a valid medical license.

An event similar to the situation above happened earlier this year, as a teenager posed as a physician at West Palm Beach, Fla.-based St. Mary's Medical Center for a month before being exposed as an impostor by an actual physician. According to the hospital, the fake physician "never had contact with any hospital patients and did not gain access to any patient care areas of the hospital at any time."

Another similar event happened in Maryland, when, in 2013, a woman forged a physician assistant certificate, posed as a PA and treated or diagnosed 137 infants and children before being discovered as a fraud. She was recently sentenced to three years in prison.

These unfortunate situations and others like them can be avoided, says Sally Pelletier, chief credentialing officer for Greeley Company. There are two main ways physician impostors end up in hospitals: security issues and issues with credentialing processes.

In the instance in Florida, the fake physician situation was likely driven by security lapses, Ms. Pelletier says.

Hospitals in the U.S. have varying degrees of security for visitors — some let visitors roam the halls at ease without checking in, while others require visitors to sign in on paper or electronically. "Don't get duped just because someone has a uniform on," Ms. Pelletier urges, advocating for hospitals to adopt a security badge authorization system if they haven't already.

In any case, Ms. Pelletier says hospitals should "do a risk assessment and find where they fall flat" in terms of security to make sure people do not end up where they shouldn't be.

On the credentialing side, hospitals can do several things to make sure every physician trying to gain credentials is properly qualified and eliminate those who have red flags. Ms. Pelletier recommends the following:

  • Ask comprehensive questions (and then verify). The application is extremely important in this process, and hospitals should ask comprehensive questions of any clinician seeking credentials. For example, the application should ask physicians to detail not just where they completed their residency, but ask instead for all residency programs they started. Attending multiple residency programs can be seen as a red flag, Ms. Pelletier says, and physicians likely won't reveal that information unless directly asked about it. Similarly, hospitals should ask about any other clinical experience the applicant has in a different capacity, like treating patients as a registered nurse or a physician assistant. "That may be a red flag [that] there is something in their past you want to find out about," Ms. Pelletier says.
  • Attach a picture. When requesting professional references, organizations should attach a current photo of the applicant and ask the reference if this is the person they are referring to. This is an extra step hospitals can take to make sure the person applying to the open position is indeed who he says he is.
  • Complete a background check. Though this step is often not required by accreditation organizations, this has gone from a leading practice to one of the fastest growing industry standards, Ms. Pelletier says.

These are just three suggestions to make the credentialing process more comprehensive — and the more comprehensive the process is, the less risk hospitals have of facing a physician impostor situation. "Recognize that a good process mitigates risk, so you want to be proactive and put the time and resources into structuring the credentialing process," Ms. Pelletier says.

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