Performance

Role of organizations
It is widely understood by all stakeholders we met with during this review, that those who own a public hospital (HAs and DF) have responsibility for granting
physician privileges. However, there are two areas where the Ministry and the College are involved in programs that create exceptions to the current processes
for privileging and credentialing:
BC Locum Program
Some managers within HAs raised a concern that some physicians may view their inclusion on the BC Locum Program (BCLP) registry as legitimacy to practice
as a locum without having to formally apply for privileges. The current system may have potential to be used inappropriately and the Ministry cannot easily check
the credentials of those registered.
The College’s role in credentialing diagnostic imaging restricted activities for the purposes of billing
As discussed in Chapter 3, the College currently plays a statutory role in reviewing credentials of physicians seeking privileges for restricted activities in diagnostic
imaging within a HA-governed facility. This is solely for the purposes of the physician gaining approval to bill the MSP, and the College expects that the HA is
performing its due diligence in granting privileges and monitoring performance.
There are two challenges with this role:
The College’s by-laws do not enumerate this role and consequently the Senior Deputy Registrar (who at present manages this process) may be
operating outside his approved mandate; and
There was no strong justification provided to substantiate why the College would approve credentials for the purpose of accessing the MSP, when the
HA is reviewing credentials to approve privileges anyway.
Most stakeholders agreed that this was not an appropriate role for the College, although it would require a change in statute if the role were to be performed by
another body/other bodies (i.e. the HAs).
Communication
Through this review we found that the terms ‘Credentialing’ and ‘Privileging’ were used interchangeably, particularly in using the term credentials to refer to the
privileges that a physician has within a practice setting. We identified that this was a contributory factor in perpetuating communication differences and confusion
both between and within organizations.
Communication issues as they relate to credentialing and privileging are primarily associated with performance management information being shared across the
system to inform privileging decisions. These issues are discussed at greater length in the performance management section below.
Ministry of Health 35
Provincial Review of Physician Licensing, Credentialing, Privileging & Performance Management
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