After graduating from Southern Illinois University Medical School in 1983, Dr. Michael Swango began a medical career that lasted longer than a decade. Along the way, some investigators have theorized, he poisoned as many as 35 patients. Ultimately, Dr. Swango's career came to an end last September when he pled guilty to four murders-by-poisoning, but the case has left open a larger issue: How did he maintain access to patients for so long? The answer, claim some, is repeated credentialing failures. When Dr. Swango moved from employer to employer, the institutions allegedly did not check his criminal background thoroughly or verify his licensure history-both which could have revealed serious discrepancies.

Although cases like this are the rare exception, outpatient surgery facilities still risk too much when their credentialing process is lax-including losing accreditation and malpractice and corporate liability suits. Approximately seven percent of physicians make a serious falsification or omission on their applications-such as a failure to report a lack of board certification, malpractice suits, or participation in numerous residency programs-and up to 30 percent make less substantive, but potentially pertinent, errors or omissions. Even perfect candidates can make mistakes during their careers, and if the credentialing process was in any way capricious or inconsistent from practitioner to practitioner, the facility can be liable.

The problem with credentialing, though, is that the task often seems so onerous that it is difficult to determine how to do it well, much less efficiently. In this article, we'll offer six tips for streamlining the credentialing process while ensuring completeness and accuracy.