What Is Negligence In Credentialing?

Negligence means a guilty conduct because it falls short of what a person would do to protect another person from a preventable harm or risk. If a healthcare facility could possibly foresee that a physician isn't qualified and the physician injures a patient, the hospital is separately liable for the negligent privileging and credentialing of the physician. Healthcare facilities are legally responsible under multiple theories. Some of them have been held responsible for the failure of the thoroughly screen a physician through the processes of credentialing and privileging, or for negligent credentialing. Negligent credentialing is recognized by at least 28 states. However, there are other theories under which hospitals are held responsible.
Liability theories
There are states where negligent credentialing falls under the corporate negligence doctrine or corporate liability. The main idea of the theory is that when patients enter a hospital they do so with a reasonable assumption that the hospital will try to cure them. Hospitals have the duty to make a lot of efforts to monitor and evaluate the treatment and care administrated and prescribed by the providers practicing in the facility. Hospitals are also responsible for granting privileges only to professional, competent physicians.
The governing body is responsible for making final decisions in credentialing and privileging matters. Although the Board Certification can also be partially responsible, since they verify physician's information regarding his/her experience and training, the ultimate decision-making power belongs to the governing body.
There are two doctrines that make hospitals responsible for hiring unqualified providers. Patients can't choose the practitioners, so it's a healthcare facility who should carefully decide who can be a member of the organization and who can't.
Elements of Negligence
Patients should understand that the fact a hospital didn't credential a physician adequately doesn't mean that the healthcare facility was negligent. For instance, if the hospital can't verify medical licenses for a competent and qualified physician within the requirements of the credentialing standards, this shouldn't be seen as negligence.
In order to establish negligence, one should analyze specific elements. For example, there should be a duty to exercise due care, and duty must be breached. There is also has to be an injury, and the breach of duty should be a reason of the injury. Besides, the patient bringing the charges has to prove that the injury caused him/her compensable damages.
As it was illustrated in a previous example, let's imagine that a physician injured a patient and it was proved that the injury was a result of negligence. If it was proved that the healthcare facility failed to verify the experience, qualification, and competence on initial appointment, and if it would have found that physician's licensure was suspended, only then it can be assumed that proper credentialing wouldn't lead to the injury. In this example, it's pretty easy to conclude that the breach of duty to properly credential that physician could have led to the injury of a patient.
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