The Importance and Meaning of Medical Credentialing
- Author Jeremy Smith
- Published March 1, 2011
- Word count 407
When looking for a health care provider, it is extremely important to know about physician credentialing. Having a physician with the proper training and licensing is vital to good medical care, and no medical practitioner should practice without the appropriate licensing.
There are several important factors to remember when researching medical credentialing. Information on physician credentialing can be found in several places. This information can usually be obtained from the doctor or his or her office, a local medical society, if the doctor is a member, or local hospital, if the doctor is a staff member there. If the physician is a member of an health maintenance organization (HMO), the HMO may be able to provide information on medical credentialing for that physician.
It is also possible to research medical credentialing for specific physicians online. The state in which the doctor practices or is licensed determines how easily accessible that information is. Some states post information on a physician’s license, specialty certifications, disciplinary actions and malpractice lawsuits on the internet. Other states do not readily provide this information online, although it is usually possible to find out most of the information on regarding specific physician credentialing through government run websites or websites run by private organizations.
With technology today, it is also possible to determine if a physician has attempted to leave behind a bad disciplinary record in another state or location. An organization called the National Practitioner Data Bank monitors the actions of licensing boards, professional societies, hospital administrators and malpractice insurance companies, to ensure that medical credentialing is accurately reported between states. This databank is not available to the public, but is used to ensure that doctors providing care are properly licensed and have no license suspensions or revocations.
Doctors must pass specific exams that allow them to be licensed to practice medicine. The specific exams that they must take depend on their degree program, medical school and location of intended practice. States control the licensing and medical credentialing of practitioners and health care providers, including physicians, are required to renew their license on a regular basis.
Doctors are also required to have credentials or privileges at hospitals where they work. This ensures that patients receive the highest standards of care from licensed physicians who are familiar with the hospital and the practice of medicine. Hospital privileges allow practitioners to treat patients at the hospital, including performing procedures like surgery using the hospital facilities.
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