When attending to patients, medical facilities are generally required to ensure that the services they offer satisfy stringent quality standards. For example, the facilities must spare no effort in minimizing the harm to which patients are exposed. Among the steps that these facilities can take to deliver safe and high quality care is ensuring that their practitioners are qualified and proven to be competent. This step underscores the importance of credentialing. Essentially, through credentialing, facilities are able to verify the professional and educational qualifications of their personnel. The case of Not-Much-Moore (NMMMC) Medical Center symbolizes the crucial role that credentialing plays. This facility has a duty of care to its patients and if it truly wishes to shield itself against liability, it should only permit credentialed physicians to perform surgeries.
Duty of Care
NMMMC owes a duty of care to all of its patients. Essentially, duty of care is an obligation that requires all medical service providers to adhere to safety standards and insulate their patients against foreseeable harm (Morris, Chawla & Francis, 2019). If this duty is breached, a facility could become the subject of a negligence lawsuit. Since NNMMC permits Dr. Anthony Follies, a practitioner who has not been credentialed, to perform surgeries, this facility commits a serious violation of its duty of care to patients. As already noted, credentialing enables healthcare institutions to safeguard the health of their patients by insulating them against harm. Among the key purposes that credentialing serves is that it enables the institutions to confirm the licensure, credentials, professional, and the educational backgrounds of their practitioners (“Ambulatory Care Program”, n.d.). Suppose that Dr. Follies presented forged documents during his application for employment at NNMMC. It could be that he was forced to forge the documents because he failed his exams or lacks the professional experience needed to safely perform surgeries. If this is the case, the hospital is exposing its patients to the risk of serious harm. It is understood that among the leading causes of the harm that patients endure is medical institutions employing unqualified personnel (Sheikhtaheri, Sadeqi-Jabali & Hashemi-Dehaghi, 2018). Therefore, by failing to insist that Dr. Follies be credentialed before carrying out surgeries, NNMMC breaches its duty of care.
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NNMMC fails to fulfill its duty of care because it appears to have a culture where incompetence and violation of established patient safety requirements are routinely flouted. In the case brief, it is noted that two witnessed accused this medical center of lacking a keen interest in ensuring that Dr. Follies receives board certification as part of the credentialing process. The testimonies of these witnesses clearly show that NNMMC has an institutional culture that condones incompetence and threatens patient safety. According to Farokhzadian, Nayeri and Borhani (2018), an organization’s culture is among the factors that influence its commitment to patient safety. Such incidences as medication errors and negligent conduct among practitioners are therefore more common in facilities whose culture does not recognize the value of patient safety. NNMMC’s culture means that this facility violates its duty of care and the patients treated here face a real and significant threat of suffering harm. The serious failures at NNMMC help one to understand that hospitals owe their patients duty of care. Among the ways through which they can deliver on this duty is demanding that all physicians wishing to perform surgeries are satisfactorily qualified before being authorized to execute the surgeries.
Liability
When medical institutions like NNMMC employ and allow physicians without credentials to perform highly sensitive duties, they face the risk of liability. Among the liabilities that the institutions face is being denied payment for the services offered by the non-credentialed physician. Generally, Medicaid and many private health insurance companies in the US require that in order to receive reimbursement, healthcare institutions must show that the physicians who offered given services have undergone the credentialing process (Liles, 2019). If this requirement is not met, these insurance providers have the authority to refuse to release payments to these institutions. Therefore, NNMMC acts against its financial interest by allowing Dr. Follies to continue performing surgeries despite being uncredentialed.
Another liability that such organizations as NNMMC face concerns negligence. Across the US, states have enacted laws and policies that make medical institutions liable for the actions of their personnel when these institutions fail to exercise due caution (Wolper, 2012). By hiring an uncredentialed surgeon, NNMMC violates these laws. As previously stated, NNMMC’s patients could experience adverse outcomes following treatment by Dr. Follies. While Dr. Follies will bear primary responsibility for any harm that he causes, the hospital will also be held liable. Under the concept of joint liability, even when an entity is not directly responsible for injuries or harm, they can still be required to pay damages. Therefore, NNMMC and other facilities whose personnel are not credentialed should expect harmed patients to file negligence lawsuits and demand compensation.
In conclusion, NNMMC represents medical institutions which do not regard patient safety with the seriousness it deserves. Despite having a clear understanding of the importance of credentialing, this facility permits Dr. Follies to conduct operations. There is no doubt that NNMMC creates an unsafe environment and it would not be surprising if patients experience complications. To safeguard its image, protect its financial health and demonstrate its commitment to patient safety, NNMMC should suspend Dr. Follies immediately. It should only allow him to resume his duties after he has undergone credentialing and received certification. Furthermore, this medical center should overhaul its organizational culture and approach patient safety with greater seriousness and dedication.
References
Ambulatory care program: the who, what, when and where’s of credentialing and privileging. (n.d.). The Joint Commission. Retrieved January 21, 2020 from https://www.jointcommission.org/-/media/deprecated-unorganized/imported-assets/tjc/system-folders/blogs/ahc_who_what_when_and_where_credentialing_bookletpdf.pdf?db=web&hash=CD838EB80D69FE2FA517285B4F3A0537
Farokhzadian, J., Nayeri, N. D., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC Health Services Research. doi: 10.1186/s12913-018-3467-1
Liles, R. (2019). The dangers of billing payors for the services of non-credentialed dentist/non-participating dentist. Liles Parker. Retrieved January 21, 2020 from https://www.lilesparker.com/2019/08/17/the-dangers-of-billing-payors-for-the-services-of-a-non-credentialed-dentist-overpayments-false-claims-act-penalties-criminal-prosecution/
Morris, C., Chawla, G., & Francis, T. (2019). Clinical negligence: duty of care. British Dental Journal, 226, 647-8.
Sheikhtaheri, A., Sadeqi-Jabali, M., & Hashemi-Dehaghi, Z. (2018). Physicians’ perspective on causes of health care errors and preventive strategies: a study in a developing country. Iranian Journal of Public Health, 47 (5), 720-8.
Wolper, L. F. (2012). Physician practice management: essential operational and financial knowledge. Burlington, MA: Jones & Bartlett Publishers.
