It Got Harder

Every few months, just after I felt like I was knocked down and just getting my feet back under me, I would be knocked down again.

I could almost time it to every three months.

6 months in – my coworker goes out on leave of absence.

8-9 months in – I had all of the reappointment files dumped on my desk.

12 months in – exactly – this schlub was convinced to take over the credentialing position at the new facility.

My Director and coworker both came to me and asked me if I would consider being the full-time employee, responsible for all of the credentialing, for the new facility.  My first response to them was, “I am neither knowledgeable enough nor experienced enough to take on a new facility, with new challenges, and be solely responsible for it.”

I was told:
“Nonsense!  You are great at this job!”
“We’ll be right here helping you with the transition.”
“It’s no different that what you are doing now, just for a different facility.”

I talked to my husband.  I talked to my friends and family.  No one could give me solid arguments against taking the job.  They barely knew what I did – *I* barely knew what I did – they couldn’t advise me one way or the other.  They all said the same thing – you’ve always succeeded in what you set out to do – why would this be any different?

I should have listened to my initial gut reaction.

My very first day in Medical Staff was on November 6, 2012.  My official transfer date to the new facility was November 5, 2013.  One year.

Thankfully, I didn’t have to actually transfer offices – my desk just changed.  I still reported to the same office location, still had the same coworker to ask questions to – but my Director was no longer my Director – I now reported directly to the new facility’s President.

Did I mention that I had never even credentialed a new applicant before November 5, 2013?  I hadn’t touched, opened, or looked at a new applicant’s file or application.  I was not taught how to review a reappointment application – so I guess they never thought it would be important to go over new application training either.

Just because I transferred positions and entities, did not mean that any of my actual job duties transferred with me.  I switched desks, they hired a new coworker to take over my original duties, but I continued doing all of the original tasks while training the new employee and credentialing reappointment files from the first entity.  My first coworker continued doing all of the new applicant files for the new entity.

When I questioned this, I was told, “You aren’t ready to take the new files over yet.  When you’re ready, we’ll switch.”

Confusion abounded with everyone outside of the office.  They didn’t know who they should be talking to.  They thought I was their new employee, so they would call me, only for me to transfer them to Coworker – who actually knew what was going on.

In the mean time, I was gaining no momentum in my job.  I kept hitting areas that were causing me to spin my wheels and get nowhere.  I kept asking myself, “Why is this so hard?”  From all indications, we had an awesome software database that should be able to do what I wanted it to do.  From what I could tell, there were advances in many aspects of the credentialing process, so why were we still mailing out letters through snail mail?

I remember distinctly a conversation with coworker:  After I printed a request for Medical Education for a foreign country, she handed me the stack and said, “Good luck receiving the verification back.  Foreign countries almost never respond and when they do, it takes weeks, sometimes months, to hear back from them.”  I was left with the impression that I was doing the correct steps, the steps are just hard to complete.

Several months later, I found out about the ECFMG (Educational Commission for Foreign Medical Graduates) from a completely separate source.  YOU MEAN I CAN LOG INTO A WEBSITE, ENTER IN A COUPLE OF KEYSTROKES AND HAVE A FOREIGN COLLEGE VERIFICATION IN LESS THAN 5 MINUTES?!?

To say I was livid when I discovered this – that is an understatement.  What irritated me most of all was learning that my coworker knew all about this process and did not say something when she discovered I was printing letters to send to foreign countries.  I found out we had an account with the ECFMG for crying out loud!  This is something she did on a routine basis!

Around this time frame is when I finally conceded to myself that my original training had been lacking.  I began branching out of my office, asking others in the industry for advice, help and assistance.  I no longer trusted the advice I was receiving from inside my department.

You would think that things would start getting easier for me at this point.  You would be wrong.

What crazy simple solution did you learn about after you struggled with a task?



Learn The Database

My next challenge was to learn the database that we used to store all of our provider information on.

There are several different software systems out there:

  • Cactus
  • Echo
  • MD-Staff
  • Morrisey/MSOW
  • And probably a whole bunch more that I’m not aware of

My particular company uses MSOW, but I have heard from others that Cactus and Echo are similar systems, with similar features.  I’m willing to guess that the other programs that I’m not familiar with are the same with similar systems and similar features.  The point of this post is not to highlight a specific database or to tout one as being superior to the others, but rather to speak on challenges that we all may face.

So what were my challenges in learning my credentialing database?

To begin with, remember me relating that my coworker and Director were not good trainers?  This carried over into the database realm.  I was instructed on how to log-in, how to look up a provider and which button to click on how to save “this particular document”.  Every few days, I would get another instruction on a different document and what to do with it.

The database was huge!  It had at least 2 dozen buttons, all doing different functions.  And heaven forbid you click a wrong button; you either lost yourself down a rabbit hole maze with no way out except to log-out or received a screen that might as well have said, “You’re not authorized to be here – GET OUT!”.


It was intimidating to say the least.

As I have self-taught myself many computer programs over the years, I undertook the task to learn the credentialing database.  To be honest, it took me months to learn enough for me to feel comfortable enough with the program to actually explore on my own (as I was also having to learn my actual job duties – it left less and less time to “learn” a computer program beyond immediate day-to-day needs).

Growing up with computers, I have learned that MOST programs will not allow you to delete anything without double-checking that you really really really mean to delete it.  So I would explore by randomly clicking on buttons that I had no idea what they were used for or what they did.  If it asked me to “save” or “delete”, I usually said no – especially if I didn’t know what I was attempting to save or delete!  This is how I formed the majority of my working knowledge and “expertise” in my database.

Even after 6 months of being in the program, it wasn’t uncommon for me to exclaim out of the blue to my coworker, “Hey!  Did you know ‘this’ button does ‘that’?”

I usually received a response back of, “Yes, I just don’t use it.”  Well….that explained why I didn’t know about the feature before that moment, but since I considered it an awesome feature that needed to be used I would question ‘why not’?  I would get a range of answers of ‘I just never use it’, to ‘it doesn’t work properly’, to ‘why would we use it?’.

Case in point – MSOW has a Gap Analysis feature that isn’t very obvious.  The screen it is on uses the “print” icon.  I had overlooked it for months because I didn’t need to print that particular screen.  One day, I was really struggling to figure out if there was a gap in one provider’s education/work history, so I decided to print out the various screens of information so I could use a ruler and pencil system.  Imagine my surprise when the program calculated the information for me with just a couple of clicks of the button!  I think I mildly struggled with this task for almost a year before I stumbled upon this feature.

What my coworker and Director did not tell me, that I learned on my own, that I would like to share with you now is this:

  • There is online help for your program.  Google it.  I guarantee someone knows how to do what you are struggling with if the immediate people in your office are clueless.
  • If you have the desire – dedicate yourself to learning as much as you can about your database.  I am confident that the database developer has already programmed systems to help you do your job more efficiently.  Use the database to your benefit.
  • If you have the ability within your organization – have at least one employee within your department become a certified ‘super-user’.  This will allow you access and knowledge to utilize much more than just the surface-level of your database.

What did you find challenging about learning your credentialing database?