Peeking Behind the Curtain


“Pay no attention to that man behind the curtain.”

~The Wonderful Wizard of Oz as created by L. Frank Baum

A USA Today investigative study analyzed physician misconduct over the last decade. Their conclusion — when it comes to physician oversight, State Medical Licensure Boards can be slow to act, quick to excuse, and are chronically underfunded/overworked.

According to the report, hospitals/HMOs take prompt action to restrict or cancel privileges when misconduct is evident. However, over half of offending physicians had no action taken against their medical license. Since 2001, the misconduct for the 3,000 doctors who lost privileges, but kept clean licenses, included:

  • Substandard Care

  • Incompetence

  • Unsafe Practices

  • Patient Abuse

  • Sexual Misconduct

Hospitals are required to report the loss of clinical privileges to the National Practitioner Data Bank, and many jurisdictions even require direct reports to the licensure boards. Unfortunately, institutions loathe confronting their peers and are always wary of lawsuits. Behind the curtain, health care entities often find ways to persuade physicians to quickly leave without a formal misconduct finding.

Networks must maintain constant vigilance to ensure their provider panels maintain the quality of physicians that payors/claimants/patients deserve. At OMCA, we credential to NCQA standards, are locally based, and have continual dialogue with community hospitals and physician practices.

We can, and do, peek behind the curtain.

Call us. We can do better.

William Faris, JD
Chief Executive Officer

Posted in Group Benefits Programs, OMCA