References and credentialling- Locums

[deleted497653]

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1. This is specific for those who have worked locums: How do locums providers handle the hassle of multiple past hospitals that will need to be verified at each new site? Have you had significant delays starting a new job because of this? Credentialling typically takes 90 days so I can imagine it can take longer with a longer list of places to verify.

2. Concerning reference, how do you handle this? Specifically, do you ask the same three to five people? And does this raise some questions from them as to “ why you’re applying to so many job”? I take it you can just tell them that you’re doing locums but after that fifth request, I’m sure they get tired of being asked

3. How hard is it to get a perm job after doing a lot of locums (years).

 

[KU Brendan]

1. I've found it depends how desperate the site is to get you there. When your are really needed, credentialing seems to magically occur in a day or two. Otherwise, it can definitely be a painful process, especially if you've worked locums lots of places. The more rural and small the hospital, I've found the easier and more friendly the process becomes. I just keep track of each site where I've worked, even if it was only for a weekend, and I've thankfully never had trouble when sites see it was just for a locums job.

2. I just ask the same people. Most of the references for locums jobs are really short "are you aware of him killing anyone" forms and not as extensive as ones I've seen for full time work. I'm sure this varies from site to site, though. Considering all the massive amount of paperwork we all deal with daily, a one page questionnaire about a colleague really shouldn't be a big deal.

3. I've always had a full time job in addition to locums work, so someone else with other experiences will have to answer that one.

 

[emergentmd]

You can Locums for 99 years and tomorrow get a full time job at said locums place. That is why they take locums, b/c they can't find full timers.

 

[slurpy15]

1. I've found it depends how desperate the site is to get you there. When your are really needed, credentialing seems to magically occur in a day or two. Otherwise, it can definitely be a painful process, especially if you've worked locums lots of places. The more rural and small the hospital, I've found the easier and more friendly the process becomes. I just keep track of each site where I've worked, even if it was only for a weekend, and I've thankfully never had trouble when sites see it was just for a locums job.

2. I just ask the same people. Most of the references for locums jobs are really short "are you aware of him killing anyone" forms and not as extensive as ones I've seen for full time work. I'm sure this varies from site to site, though. Considering all the massive amount of paperwork we all deal with daily, a one page questionnaire about a colleague really shouldn't be a big deal.

3. I've always had a full time job in addition to locums work, so someone else with other experiences will have to answer that one.

Did you do a FM and EM residency?

 

[deleted497653]

You can Locums for 99 years and tomorrow get a full time job at said locums place. That is why they take locums, b/c they can't find full timers.

I should clarify- how hard is it to go through credentialling at a desirable place after working a string of locums? Obviously it’s easier to land a gig at a place that “nobody wants”. However, one mans trash....

 

[deleted109597]

Most locums don't care. They might contact the last hospital you worked at. Beyond that, if they checked up on everyone there wouldn't be a roving list of transient assassins out there.

 

[slurpy15]

I've noticed that even some non-locums jobs are only asking for hospitals within the last five years. Guess they are getting sick of hunting down thirty plus hospitals...

 

[deleted497653]

I've noticed that even some non-locums jobs are only asking for hospitals within the last five years. Guess they are getting sick of hunting down thirty plus hospitals...

Slurpy, what do you do for references?

 

[Vandalia]

1. I've found it depends how desperate the site is to get you there.

As mentioned above, this is the critical factor. With its own inertia, the staff who handle the details can get bogged down in this for a long time. However, when someone is pushing to get this doc to work right away, things can move quickly. If you have a long history of locums and are worried about how long this will take for a new full-time position, it can help to ask the people hired just before you how long it took them to work through the process. This is also a good thing to check in and of itself since it gives you an idea of the ED director's clout. If it is taking 180 days for everyone in the ED, but a surgeon you know tells you it took him 14 days, then that could be a cause for concern.

The concept of "pretest probability" also applies to the credentialing process. If someone has a clean record and a straight-forward background, then most people are content not checking every place you worked for 2 days 10 years ago. On the other hand, I have had CEO's push people in other specialties who took 7 years and 2 medical schools to graduate, went to 3 residency programs, have a history of board actions and "forgot" some of the contact information for other locations. For these, you can bet that I am having them check every place they worked. Actually, on second thought, no. Usually by about the second or third place, it becomes clear that we are not approving them.

 

[arandazzo88]

Come to East TN, you won't have any problems. They're super desperate around here.

 

[deleted497653]

The concept of "pretest probability" also applies to the credentialing process. If someone has a clean record and a straight-forward background, then most people are content not checking every place you worked for 2 days 10 years ago. On the other hand, I have had CEO's push people in other specialties who took 7 years and 2 medical schools to graduate, went to 3 residency programs, have a history of board actions and "forgot" some of the contact information for other locations. For these, you can bet that I am having them check every place they worked. Actually, on second thought, no. Usually by about the second or third place, it becomes clear that we are not approving them.

So what the CEO wanted could not happen? So they can’t override the credentialling committee?

 

[Vandalia]

So what the CEO wanted could not happen? So they can’t override the credentialling committee?

I got a CEO fired who tried to bypass the credentials committee.

All I had to do was to show the board what happens if you let the wrong guy slip through. Putnam General Hospital Closing

Some background on his specific case: Judge orders ex-Putnam doctor King to pay millions

King was a staff doctor at Putnam General between November 2002 and June 2003, when the hospital suspended his privileges. During those eight months, he generated 124 medical malpractice lawsuits. The Hospital Corporation of America paid more than $100 million to settle the malpractice suits filed against King and Putnam General, which Nashville-based HCA owned at the time.

Note, I was not involved with anything related to him or that facility. But our former CEO's actions would have left the hospital defenseless if absolutely anything went wrong with the guy he put to work without privliges. Using this case as an example, I was able to show the board and the lawyers (they already knew this) that they could face 9-figure liability from one physician.

 

[emergentmd]

I got a CEO fired who tried to bypass the credentials committee.

All I had to do was to show the board what happens if you let the wrong guy slip through. Putnam General Hospital Closing

Some background on his specific case: Judge orders ex-Putnam doctor King to pay millions

King was a staff doctor at Putnam General between November 2002 and June 2003, when the hospital suspended his privileges. During those eight months, he generated 124 medical malpractice lawsuits. The Hospital Corporation of America paid more than $100 million to settle the malpractice suits filed against King and Putnam General, which Nashville-based HCA owned at the time.

Note, I was not involved with anything related to him or that facility. But our former CEO's actions would have left the hospital defenseless if absolutely anything went wrong with the guy he put to work without privliges. Using this case as an example, I was able to show the board and the lawyers (they already knew this) that they could face 9-figure liability from one physician.

"King has practiced medicine -- and had his medical license suspended or revoked -- in several states, including West Virginia, Virginia, Alabama, Florida, New York, Pennsylvania, Michigan and Indiana."

How this guy was credentialed in the 1st place was Malpractice on the hospital and credentials committee. Trails of lawsuits and license suspension should have been a no go.

 

[Vandalia]

"King has practiced medicine -- and had his medical license suspended or revoked -- in several states, including West Virginia, Virginia, Alabama, Florida, New York, Pennsylvania, Michigan and Indiana."

People slip through the cracks, that is why if you are on one of those committees you need to be vigilant.

Even more surprising/galling, he was still working as a physician even after all of that. Quality doctors and healthcare (the original article appears to be unavailable.)

The latest on him I found is from an Alabama court case where he was trying to get his license re-instated. That did not go well, but the opinion said he was currently working "shadowing" a physician in Chattanooga, TN. Dr. Sharpton said that King was knowledgeable and had displayed a caring attitude toward the patients.

CEO's are trained to get problems solved. "Well he is licensed, and he said he completed a residency... eventually... and we really need someone." It is our job to say "no." If credentials and hiring committees do not do their jobs, then the government will step in even more ... and we will not like that.

 

[Old_Mil]

King was a staff doctor at Putnam General between November 2002 and June 2003, when the hospital suspended his privileges. During those eight months, he generated 124 medical malpractice lawsuits. The Hospital Corporation of America paid more than $100 million to settle the malpractice suits filed against King and Putnam General, which Nashville-based HCA owned at the time.

Holy hell. How do you do that? That's almost a lawsuit per shift with any sort of normal schedule.

 

[southerndoc]

Good grief. I'm sure he had to have been served multiple suits in one day. Talk about a bad day!