Original Task:
Discuss your perspective on patient protections afforded by provider licensing and credentialing. Are they sufficient or not? Support your reasoning with data.
Bridgets Post:
Over the last decade there have been many improvements to protect patients from potentially harmful providers. Licensure is subject to federal (and state) Constitutional requirements of procedural and substantive due process and equal protection.1 From the state level there are boards that review any complaints or grievances of providers.
On a federal level the National Practitioner Data Bank was developed in 1986 by the Health Care Quality Improvement Act to protect the public by restricting the ability of practitioners to move from State to State or hospital to hospital without disclosing medical malpractice payments or adverse action histories at the time of credentialing, employment, licensing, or monitoring.2 This has prevented many hospitals from hiring practitioners that have a history of problems and concerns.
Prescribing is also regulated by the Food and Drug Administration and the Drug Enforcement Administration. Over the past 25 years, pharmaceutical companies deceptively promoted opioid use in ways that were often neither safe nor effective, contributing to unprecedented increases in prescribing, opioid use disorder, and deaths by overdose.3 Both the FDA and DEA have taken a stronger stance in the last 10-15 years to begin to stop the continued loss of life. Personally, as a physician assistant that worked in the emergency room for 18 years in the inner city, I saw a tremendous number of overdoses and pain due to opioid addiction stemming from problem physicians that continually wrote for narcotics inappropriately. Due to stricter enforcement, many of those same physicians are no longer practicing in the United States any longer.
On a state level, each state board of healing arts takes grievances and complaints seriously and does a thorough investigation on all providers. Nursing boards also require an investigation of complaints and concerns. These investigations are important to prevent harmful or inadequate practices from providers.
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