NSW Medical Bulletin

Australia's Advance Medical Technology

Physician Credentialing – Measuring Doctors’ Medical Professionalism

Doctor credentialing is when a health specialist’s knowledge and abilities are checked and documented. The professional licensing, training, decision-making abilities and instruction are gone over during the method. Various kinds of organizations and groups execute the procedure. Credentialing is performed to confirm that medical professionals are qualified to do the work they are doing. This prevents unqualified people from causing injury or harm to others as a result of substandard education or poor judgment abilities, and posing as professional doctors. The standards are confirmed through third-party peer review. Other medical specialists supervise the review. The procedure has to be formally approved in a lawful manner, and the physician credentialing strategies should be made transparent.

Physician Credentialing
The standards that are being measured must be linked to the manner of how the patient is treated and cared for since this grading is carried out from a health standpoint. The precise temperament of the standards will be based on the kind of work the doctor specializes in. Generally, physicians are divided into two groups. They are Doctors of Osteopathic Medicine or Doctors of Medicine. Besides this, there are various areas including psychiatry, general medicine and surgery, within each type.

Many insurance companies will refuse to compensate a company or a physician unless the physician has recently undergone the medical credentialing procedure. The physician must go through such a procedure to be able to work with patients who have Medicare. In an area with a substantial number of patients, the method exists to shield medical practitioners from the risk of lawsuits and not just to ensure security for all parties involved.

Not only are training and abilities analyzed; a background check is usually performed too. Residency, board certifications, schools, areas of internship and state medical permits are looked over and assessed. It seldom ends after employment has started and has a tendency to continue sporadically for the remainder of the professional life of a physician.