Confronting the Bureaucracy

I was in transition, working to create a new practice. Part of this process involved changing hospital affiliations, so I applied for privileges at 2 community hospitals in neighboring counties. Our state health department has developed a uniform application for medical staff privileging that has eased the pain of having to collect all of those phone numbers, fax numbers, e-mail addresses, names of current program directors, old insurance carriers, and so forth for primary source verification on the application: What I gathered for one application, I could photocopy for the other. But there are still differences between the institutions in what is required for privileging.

The first hospital required me to take many online courses developed by the university on Health Insurance Portability and Accountability Act (HIPAA) compliance and provide the continuing medical education certificates with my application. The second hospital did not require that I take these or any other course on HIPAA, but I had to report to its employee health clinic to have blood drawn for hepatitis B, mumps, measles, rubella, and varicella antibody titers if I could not otherwise document past immunization or immunity. If I did not have adequate immunity, then I would have to agree to be vaccinated as a condition for privileging. The first hospital accepted my listing of a physician assistant colleague as a professional peer reference. The second hospital would not accept a physician assistant who has worked with me for 14 years as an adequate reference.

After the second hospital received my privileging application, it sent me an urgent letter that required my signature for delivery. The letter informed me that, to complete my credentialing application, I would need to present myself at its employee …