Commentary: The Doctor Credentialing Process Is So 19th Century

In an age of technological breakthroughs, a physician leader encourages organizational leaders to modernize the process for onboarding new hires.

Medicine is progressing at breathtaking speed through this modern era. We are finding new cures to previously incurable diseases and a seemingly endless array of medical information is available at the click of a button. People are living longer, staying in hospitals for shorter amounts of time, and, thanks to telemedicine and advances in communication, can see a doctor practically anywhere in the world.

This is all fantastic.

However, there’s one aspect of health care and the practice of medicine that is hopelessly stuck in an archaic system. That’s the system of credentialing any physician before they start working in a health care facility. It’s an understandably rigorous process, of course—to ensure all physicians are verified and their backgrounds scrutinized. But given all the other advances in our industry, it’s amazing that the process is not more streamlined than it is.

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The process goes something like this in most places:

• Physician applies for a job and accepts a position.

• Physician is asked to complete mountains of paperwork. This includes work history and all previous education and licensing certificates. There are literally hundreds of pages. And it must be completed by hand.

• It can take a couple of weeks to gather and complete all the documents, and send them in by postal mail.

• The paperwork will be reviewed, checks obtained, and the hospital credentialing committee (which might meet only once a month!) will then approve the physician.

• The doctor may start work.

That process takes a long time — it could well be four months or more. It’s insane that we still do it this way.

Here’s what we need:

• Some type of recognized central repository where physicians can store all their documents and work history information.

• The whole process should be online.

• Health care facilities and licensing boards must work together. As an extreme example, a health care system might have five hospitals within 50 miles of each other, and each might have its own credentialing rules.

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Sounds so simple, right? There are, however, several barriers that exist to a more harmonious process, including every hospital having its own bylaws and rules. There’s also the legal responsibility that every facility takes on when hiring a physician, and the need to ensure thorough and rigorous checks. Not to mention the generalized sense of inertia that exists in much of the health care administration to really change things.

But no doubt, at this time of great demand in health care — with a growing shortage of physicians — it’s in every facility’s best interests to improve this process. Until then, we continue with a horse-and-cart system of medical credentialing.

Ben Levin, MD, is a board-certified internal medicine physician based in Massachusetts, and co-founder of DocsDox , an online service that connects physicians and health care professionals with independent job opportunities.