Indian Health Service

Improvements Needed in Credentialing Temporary Physicians Gao ID: HEHS-95-46 April 21, 1995

Indian Health Service (IHS) facilities, which provide medical care to more than one million American Indians and Alaskan Natives, supplement their staffs with temporary physicians. But weak policies have led IHS to unknowingly hire doctors who have been disciplined for such offenses as gross and repeated malpractice and unprofessional conduct. IHS does not explicitly require verifying all active and inactive state medical licenses that a temporary physician may have. Further, most IHS facilities that have contracts with companies that supply temporary physicians do not require the companies to inform IHS of the status of all medical licenses a physician may hold. In addition, IHS facilities do not have a formal system for sharing information on temporary physicians who have worked within the IHS medical system. This report also discusses what happens when requested medical services are delayed.

GAO found that: (1) IHS patients may be receiving substandard care because IHS is not always aware of temporary physicians who have had performance or disciplinary problems; (2) although IHS requires that temporary physicians possess a current medical license without restrictions, it fails to verify all of the physicians' current or prior licenses; (3) most IHS facilities have contracts with companies that are not required to inform IHS of the status of their physicians' licenses; (4) IHS facilities do not possess a network to share information on the performance of its temporary physicians; (5) although IHS can purchase specialized medical services from non-IHS providers under the Contract Health Services program, preventive care is not always funded; and (6) IHS is implementing legislatively required staff reductions, however, officials are unsure of how these reductions will impact future medical services or expansion programs if appropriations are reduced as well.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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