ple event has the potential to rise to the NPDB standard of what’s report- able if that physician surrenders privi- leges or goes on a leave of absence. “This is not stated anywhere, but
my presumption is that they’re look- ing to increase the number of reports that they get,” Ms. Snelson said. “They want more reports. How do you do that? Well, you cast the net wider. They’re looking at ‘investigation’ as something that begins whenever there’s any inquiry into an individual physician’s practice or professional conduct.” For example, Ms. Snelson worries
that if a hospital staffer made a casual comment to a chief of staff about a physician’s erratic behavior the other day, and the chief of staff then simply glanced at the physician’s file, the hos- pital could consider that an investiga- tion. Hilary Young, an Austin attorney who often represents hospitals, agrees the guidebook’s language gives “inves- tigation” a new breadth. But Judy Rodgers, deputy director
of HRSA’s division of practitioner data banks, told Texas Medicine the 2015 guidebook “simply clarifies the guide- lines in the previous guidebook,” and those clarifications “do not change NPDB’s long-standing interpretation of the term ‘investigation’ for report- ing purposes.” “The guidebook does not expand
the meaning of investigation to mean any inquiry,” Ms. Rodgers said. “In fact, we clarify that a routine review is not considered an investigation.We emphasize that a formal, targeted pro- cess that is used when issues related to a practitioner’s professional compe- tence or conduct are identified is con- sidered an investigation for purposes of reporting to the NPDB.” She says an inquiry should “be for-
mal and focused on a particular prac- titioner; concern that practitioner’s professional competence or conduct; and be the precursor to a professional review activity.” Under those param- eters, Ms. Rodgers says, a surrender of privileges is reportable to NPDB “even
March 2017 TEXAS MEDICINE 51
REPORTABLE ACTIONS
Certain actions related to a physician’s clinical privileges are reportable to the National Practitioner Data Bank (NPDB), and some aren’t. Here are examples, according to the NPDB Guidebook:
Reportable • A physician restricts or surrenders clinical privileges in re- turn for not conducting an investigation related to profes- sional competence or conduct.
• A physician restricts or surrenders privileges while under investigation related to professional competence or conduct.
• A facility assigns a practitioner a proctor for more than 30 days based on assessment of competence, and the proctor must grant approval before the practitioner can perform procedures.
Not reportable • A facility assigns a practitioner a proctor for more than 30 days based on assessment of competence, but the proc- tor’s presence and approval aren’t required for the practi- tioner to provide medical care.
• A physician restricts or surrenders clinical privileges for personal reasons but isn’t under investigation related to professional competence or conduct.
• An entity denies a physician a staff appointment or clinical privileges because the entity has too many specialists in the practitioner’s discipline.
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