Many MSPs are familiar with the book Blind Eye by James Stewart about a physician, Michael Swango.  If you have not read this book, you'll want to pick up a copy to learn more about why our jobs are so important to patient safety. 

Mr. Stewart reports the allegations that caused many to believe that Michael Swango may be the most prolific serial killer in American history.  The story is of particular interest to MSPs who investigate applicants for medical staff membership, privileges, and participation in health plans.  Learn how Swango's behavior was not discovered before he committed murder and poisoned coworkers. 

After reading Blind Eye, you'll wonder if you would have uncovered Swango's incompetence, misconduct and criminal behavior. 

Carole  La Pine, MSA, CPMSM, CPCS

An interesting application crossed my desk this week.

The applicant provided an explanation of a lawsuit that was filed against her.  She explained that one night when she was on call, she was asked by a nurse to come help with a patient who was "out of control".  The patient was wailing his arms, kicking and slapping at the nurse.  The doctor helped to get the patient back to bed all the time being punched and kicked.  The patient then began jumping on the bed. Fearful that the patient would fall off the bed and injure himself, the doctor tried further control over the patient.  The patient continued to kick and punch so the physician "gently" slapped the patient to get his attention.  The nurse reported the physician to administration for patient abuse.

I posed this question to several of my highly respected peers.  Here are some of their thoughts:

Carol (not to be confused with me, Carole):  I think that the physician behaved inappropriately (as did nursing) but the situation was unusual and extreme.  Unless there was a pattern of concern with this physician (previous examples of poor judgment) that this should be an interesting part of this story but have limited impact.

Bonnie:  I would want to verify her story somehow, either through an administrator at the hospital or department chair.  I would also confirm that this behavior was a single incident and not typical of her.  I would push her a little bit to see what evidence there really was to support a lawsuit going forward.  I would probably ask her for a copy of the filing papers.   Did the licensing board take any action or investigate?  Did her hospital take corrective action?

Anne:  There never is a good reason for physical abuse.  I've never heard of a "gentle" slap.  This application requires careful investigation and perhaps an interview with a physician well-being committee.

If you were processing an application, how would you handle this?

Carole La Pine, MSA, CPMSM, CPCS

The Joint Commission recently issued a statement regarding the impact to performance and patient safety when medical staff demonstrates intimidating and disruptive behaviors.  TJC indicates that such behavior can lead to medical errors, contribute to poor patient satisfaction, increase the cost of care, and be the reason some professionals would chose new positions. 

For those of us responsible for credentialing and privileging, it is reassuring to know that rude and intimidating behavior is not acceptable.  I’ve encouraged my staff to write a “Note to File” whenever a practitioner behaves inappropriately.  This information is then shared with the Department Chair when the completed file is reviewed and also noted to the Credentials Committee during their evaluation. At first this type of information was given only a quick glance.  Today it is taken much more seriously. 

We all realize the time required to complete the credentialing process and how it can be frustrating to eager-to-start practitioners.  However, MSPs, as well as nursing and other support service staff, should not endure bad behavior.  It is time to make professionalism part of our assessment of practitioners’ qualifications. 

Carole La Pine, MSA, CPMSM, CPCS