It is difficult to underestimate the role of medical staff in the process of treating patients, who entrust their health and lives to doctors. That is why it is the main duty of the hospital to ensure competency of their personnel, so that there are no doubts as for the level of their professionalism. In the current case study the patient died because the physician was not qualified enough to cope with cholecystectomy and the hospital was definitely responsible for giving inadequate privileges to the doctor who was not ready for this task.
It is possible to apply the term “credentials” to the wide range of notions, such as certificates, licenses, registrations, recognitions or accreditations. It is supposed that the physician who has those credentials is qualified enough to meet the standards established by the government concerning the health care. It is also important to mention that license and certificates are not of equal value and do not suppose the same level of professional competence. Certification does not give the right to perform the activity that is potentially dangerous to others, and surgery can be referred to as the potentially dangerous activity.
Laparoscopic Laser Cholecystectomy
In the discussed case study, Doctor Freeman acquired a certificate proving his professional ability to treat gallstones with laparoscopic laser ten days before the operation in the course of which the patient bled to death. He was given permission to do it on the basis of temporary privileges. It is evident that the physician who did not have enough experience in surgery in general and laparoscopic laser surgery in particular, which is even more difficult to perform, had no right to do surgery to the patient. In addition, the person can not be given any privileges in surgery after the only workshop, because this task requires much effort and time for learning. In case there were no other specialists who would be able to deal with the disease of the patient, the hospital had to find such specialist or ask the patient to look for another hospital. Gallstones are not a problem that requires urgent surgery and there was no objective need for giving temporary privileges to doctor Freeman. All these facts support the issue of the case study that it was a negligent decision of the hospital to allow Doctor Freeman to perform surgery and grant him such specific privileges. Perhaps, it would have been better to find another experienced physician to perform the laparoscopic laser cholecystectomy, and Doctor Freeman would have been his assistant. In this case, the chances of the patient to survive would be higher, and Doctor Freeman would get the practical experience that he needed after the single workshop in the laparoscopic laser cholecystectomy.
As it was mentioned earlier, the hospital is responsible for checking the professional level of the personnel and ensuring that the patients receive qualified medical care. In case a physician is asking for certain privileges in work, the hospital needs to take a number of measures to check whether he/she has enough knowledge and skills to perform this procedure.
- On the first stage of verification the hospital should check the physician’s competence and primary credentials. A physician has to take an official application that is required for asking for privileges, complete it and then submit it to the department that is responsible for medical services. Their primary credentials must be checked and then the primary competency of the applicant needs to be evaluated. In case the candidate does not have official documents that show his/her experience in the desired field of work, the hospital should conduct the evaluation of his/her specific professional experience.
- The second measure the hospital should take in checking the professional level of the physician and deciding whether he/she is ready for certain work is checking of the applicant’s competence, setting the responsibilities, and making the decision about his/her readiness for work. It is necessary to note that the decision about the applicant’s qualification should be made by the committee of other physicians in the hospital. It is not difficult to organize it in practice, but still it requires time and skills. The committee has to be the main structure that allows the medical personnel to have certain privileges or rejects their applications. They should review the documents and credentials and assess the physician’s competence during the interview, if needed. The governing body of the hospital has the right to reject the candidate, who was proposed by the credentials committee. However, it is not capable of giving privileges to those candidates, who were not approved by the commission.
However, not only those clinicians who want to acquire new privileges have to be checked. All medical personnel in the hospital need to undergo regular professional evaluations, because the lives and health of the patients depend upon their competence. The example from the analyzed case study shows that lack of investigation can lead to fatal results. Doctor Freeman did not have enough experience to perform a difficult surgery, and it is strange that someone gave him temporary privileges to do it. The certificate he has received after the only workshop cannot be called a serious credential to allow him perform the laparoscopic laser cholecystectomy. The fatal outcome of the neglected responsibilities supports the idea that the hospital must guarantee that a physician is qualified enough to perform the needed procedures.