About eight months into my employment with the Medical Staff Office, we were hit with another HUGE challenge.
Even though my coworker and my Director both complained that our office was understaffed (which I agreed with whole-heartedly), the Director maneuvered our facility into the position to accept the challenge of credentialing providers for a brand new entity that our company opened up. That meant we would be responsible for our providers, plus another hospital’s providers.
I will never forget how round my coworker’s eyes became when our Director relayed the information to us. We were told at the end of June, the facility would be opening up mid-September – we would have less than three months to completely credential enough new applicants/providers to fully staff a fully functioning new hospital. Did I mention at the time we did not have any Bylaws, no privilege forms, and Databank was not set up (or any other systems set up for that matter) for this new facilty?
When we went back to our desks, my coworker grabbed a pile of reappointment files off her desk, walked to mine, dropped them with some force onto my desk and stated, “These are now yours. I won’t have time to do them anymore with the new hospital.”
I sputtered, “But I don’t know what I’m doing with these!”
Her, “Nonsense. You were working the files just fine when I was gone on leave of absence. Just keep doing what you were doing.”
Me protesting to both the coworker and Director was met with denial that I needed more training, assurance that I was doing just fine, and the expectation from both that I would take over and complete the reappointments for that month and going forward.
I learned the hard way that I needed to ask more questions.
I didn’t ask for case lists – let alone know how to read them and interpret that there were enough cases for specific privileges.
I struggled with communicating with the doctors and their credentialing staff. I approached them like I had in my other positions – a weak email request with a “if you wouldn’t mind” tone rather than firm statements with hard deadlines. I didn’t know that I would need to babysit and follow up with them, sometimes multiple times, just to get them to follow through on simple requests.
I could check the items off my database checklist just fine, but I had no idea if files were considered complete or not. I had no one suggesting that my files be audited or that I audit myself. I had no idea what an audit was!
I learned, years after the fact, that I wasn’t even taught how to review an application to determine if it was “complete” or not.
I cobbled together most of my working credentialing knowledge from trial and error, being repremanded that I missed something major, or from overhearing something someone else was talking about at a meeting or conference.
In between learning how to credential a reappointment file, I was also learning about Stark Laws, EMTALA and ER call schedules, planning and booking multiple attendees to out-of-state Horty-Springer conferences, leadership contracts and dealing with a “hostile-take-over” of a department chair position (that was fun).
The only thing that could have made that first 9 months worse was to throw in there a lawsuit and Fair Hearing. Thankfully, that didn’t happen, but I did learn something about it as we were contacted by the State Medical Board regarding one of our physicians being investigated.
Nevermind the fact that I also attempted to have a life outside of work.
I relay all of this information to assure you, the reader, that you aren’t the only one struggling with this job. It’s the new millenium for crying out loud! Why are we struggling to learn these things?
Maybe it’s because, like me, I had people who didn’t know how to train. Maybe it’s because you have an entity or leadership that is still stuck on doing things the old ways. Maybe it’s because you, like me, don’t know any better and just doing what you can to get through another day.
What horror stories do you have from your first year?