The case study depicts a patient who was referred to a doctor who advocated a laparoscopic laser cholecystectomy, but the patient died as a result of the procedure. It is one of the most prevalent medical issues, with the complainant claiming that the doctor was unqualified to conduct the surgery. Nonetheless, based on the doctor's qualifications, it appears that he was justified in doing the treatment because he had been approved by the medical institution. The complainant's proof of a negligent act in the case scenario demonstrates that there were severe issues in the facility's credentialing and privileging processes, which resulted in the loss of life. Credentialing involves the assessment of whether the medical professional is qualified to perform the process that they are requesting. One primary mistake in credentialing that Dr. Freeman made was failing to report the adverse peer review action to the appropriate authorities (Seak, 2014). Many medical institutions require that a physician reports the adverse peer review action and clinical privileges and even though it is not as serious and affirmative as it seems, the failure to adhere to the requirement has adverse effects. The doctor ought to have shared the progress of the condition with Dr. Thomas in case the patient’s state was worsening. It is seen, however, that Dr. Freeman never shared the progress and made the complaint use it as a justification for carelessness. It tainted the physician’s reputation because the failure to report the incidence meant that it was a violation of the bylaws and agreements (Seak, 2014). It is possible that the inability to report may have been inadvertent, but it still meant that Dr. Freeman dreaded cover –up. The complaint thus proves why his claims are justified because it is seen that the doctor involved failed to report adverse peer review action and thus acted with negligence.
The other major issue in credentialing that is apparent from the case description is that the failure by the physician to monitor their own medical staff records. Usually, the mistake that many physicians make is to wait until there is a peer review action threat that they begin reviewing their medical staff and credentials (Seak, 2014). The recommended protocol is that once the appointment application is accepted and filed, the professional ought to review the file and ask for a review of both the credentials and peer review files. In the case presented, however, the only trace that is made to Dr. Freeman’s records is that he was granted the privileges to perform the procedure based on a certificate he had received after completing a laparoscopic laser cholecystectomy workshop, which he took on February 10, 1990, a week before the death of the patient. It is apparent, therefore, that there was an act of negligence and ignorance by the doctor checking and updating his qualification to perform surgery.
It is important to note that apart from the issue with credentialing, there are also concerns over the privileging processes and procedures that are used in the facility. There are two main ways in which a hospital can use to determine the competence of the physician requesting for the procedure they intend to perform. One way is through the traditional technique which involves submitting a laundry list of the procedures and treatment that they wish to do and the prove that they are qualified to perform the procedures. The method is appropriate as it allows for professionals to select only those tests that they are certain and qualified they can perform (American Medical Association, 2010). The only challenge with this form of privileging is that when the medical personnel forgets to mark a test, they will not be permitted to perform it even if they are qualified.
The other technique involves the process referred to as core privileging. The process entails the physician picking the predetermined group of processes that are applicable in the specialty. A cardiologist would, for instance, pick heart related procedures and tests. It is then the burden of the medical staff to include or exclude the specific tests in the core privilege list. It is, however, important that in either case, the applicant need to have undergone the proper training, education, and stay relevant an up-to-date within the minimum standards that are applicable, from which they can prove their qualification (The Medical Protective Company, 2014).
In conclusion, it is apparent that the case scenario presented represents a failure in the adherence to strict credentialing and privileging processes that led to mortal consequences after the patient succumbed to death in the process of undergoing medical treatment. The major issues in credentialing involved are that there was no reporting of adverse outcomes to the peers and the physician’s failure to keep abreast with their qualification. It is thus recommended that in such cases the traditional and core privileging techniques are used to ascertain whether the physician is qualified to perform a medical procedure.
References
American Medical Association. (2010). Physician Credentialing and Privileging. Policy 21. Retrieved from http://www.acmq.org/policies/policy21.pdf
Seak, K. (2014). The 10 Biggest Legal Mistakes Physicians Make in the Credentialing Process. The Biggest Legal Mistakes Physicians Make: And How to Avoid Them. Retrieved from http://www.seak.com/blog/uncategorized/10-biggest-legal-mistakes-physicians-make-credentialing-process/
The Medical Protective Company. (2014). Credentialing and privileging. Credentialing and Privileging. Retrieved from https://www.medpro.com/documents/10502/359074/Credentialing+and+Privileging.pdf
