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Medical License Verification to Minimize Medical Negligence and Medical Malpractice

A 1984 Harvard study of more than 30000 records from 51 randomly selected hospitals in New York found that adverse medical events occur in the more than 3.7% of patients admitted and that more than a quarter of these were due to medical negligence. Close to 14% of the adverse medical events were fatal and 2.6% resulted in severe disability. When extrapolated to the 2.7 million patients discharged from New York hospitals that year about 13,450 people died and 2250 were seriously injured. (When Doctors Kill By Stephen J. Cina, Joshua A. Perper).

These are the stats which are showing the medical malpractice and medical negligence issues of the most prominent and advanced city of the world. After reading those horrible figures one can understand that the world is suffering from medical malpractice and negligence on a much higher scale and the prevention only lies when we background check our doctor or medical practitioner through primary source verification, medical credentialing and by medical license verification.

Investigation and verification of medical license can assure you the safety and integrity of the doctor or a medical practitioner you are going to get treated. To practice medicine, a practitioner must obtain a license from the appropriate state licensing agency (i.e. state medical board). A physician usually applies for a state license after completing medical school and passing an examination that established his or her knowledge in the basic sciences.

When a medical professional is suspected of a board violation, he or she will likely be investigated to determine if disciplinary action is necessary. The conditions for discipline vary from board to board and state to state, but there are some rules that are adopted by all or almost all professional boards. Some of the common grounds for discipline include:

• License registration or renewal fraud

• Verify license, expiration date, and sanctions or limitations.

• Medical practice misconduct, fraud, or negligence

• Committing a health law violation

• Practicing while a license is pending or suspended

• Practicing while under the influence of alcohol or drugs

• Alcohol or drug dependency

• Committing a criminal offense

• Qualifying as mentally unstable or insane

Core Criteria for Medical License Verification

The core criteria followed by different international organizations like joint commission international for medical license verification is performed at the time of initial appointment, and at the time of each reappointment and/or re-privileging, and is recommended at the time of license expiration. The following points must be considered while performing medical license verification:

• Date and time of the license issuance.

• State of licensure, license number, date of original licensure and expiration date.

• Name (first and last) of the person initiating the verification call

• Name (first and last) of the person verifying the information

• Are there any current, past, or pending restrictions on the license?

• Are there any current, past, or pending disciplinary actions against the practitioner?

Peer Referencing is Essential for Medical License Verification

Peer Referencing is very important when medical license verification process is live. A peer must be someone who knows the doctor or medical practitioner from past three to five years. If the applicant is finished training during past three to five years the peer referencing letter must be from his/ her training program director. And at least one reference from the practitioners specialty which marks the reputation and competency factors.

What to verify:

1. Relationship of peer to the applicant (Training director, colleague practitioner, etc).

2. How the peer is aware of applicant’s current clinical competency.

3. Validation and confirmation by the peer of the applicants request for clinical privileges.

Potential verification Method: Send a letter, and a questionnaire directly to the peer reference.


Every medical professional must be licensed in order to legally practice medicine. Licensing boards are run at the state level and dictate the licensing requirements and conditions for all physicians or nurses within a particular state. These boards oblige all licensed individuals to meet certain criterion in order to remain in good standing. If a medical practitioner whether a doctor or nurse acts in a way that violates the code set by the board, he or she could be put on probation or could have his or her license revoked altogether.

Muhammad Saad Khan is a Research Analyst at Q2 Group. Q2 is specialized in medical credentialing, primary source verification, and medical license verification according to the standards of joint commission international.