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NEWS Demystifying Privileging and Credentialing Answers to frequently asked questions By DR. LYNNE HARRIGAN Vice President, Medicine and Integrated Health Services, Nova Scotia Health Authority T here is confusion around privileging and credentialing of physicians and the way in which new and replacement positions are approved. The Nova Scotia Health Authority (NSHA) has been working for the past 18 months to clarify claims that physicians are being restrict- ed from practice through denial of privileges. How are positions approved? New and replacement positions are approved by a committee comprised of representatives from the Department of Health and Wellness (DHW), the NSHA and other stakeholders. When the NSHA joined the committee in 2015, it was agreed that all departing family doctors would be replaced. Changes made in May 2017 have improved flexibility for family physicians. Replacement positions were originally tied to the practice loca- tion of the departing family physician. These are now considered provincial vacancies, meaning an incoming physician is able to work wherever they want. The position approval process is separate from the privileging and credentialing process. Changes to provincial vacancies occurred as a result of constructive feedback and dialogue with physicians and stakeholders. It is important for the NSHA to be responsive to the changing needs of communities.  What is privileging and credentialing? Privileging and credentialing happens after a physician has an approved position. Privileging outlines a doctor’s level of access to NSHA facilities and resources. Credentialing verifies their insurance, education and licence details. This process is repeated every three years to ensure continuing education, quality of care and patient safety; similar processes occur across the country. Each zone has a privileging and credentialing committee. Physicians work within the zone committees to provide recommendations to the Health Authority Medical Advisory Committee. According to NSHA records, no physician has been denied initial privileging to access NSHA resources and services since 2015. When did privileging and credentialing of family doctors begin? While privileging and credentialing of specialists and family doctors who work in hospitals was always in place, the process was extended to community-based family doctors in 2015. All practising community-based physicians were given privileges. This process took longer than anticipated, which could be a source of some of the confusion around restrictions. can practise where they wish. All departing family doctors are replaced. Does the NSHA deny privileges based on geographical boundaries? No physician who has gone through the privileg- ing and credentialing process has been denied initial privileges. All replacements are approved. Each outgo- ing physician creates an available provincial vacancy; outgoing physicians with large patient rosters may be replaced with more than one position. Recently, measures were put in place to allow an incoming physician to work alongside an outgoing physician. This provides an opportunity for mentorship; the overlap may last up to three years. Reach out For more information about privileging, cre- dentialing and position approvals, contact Lynne Harrigan at lynne.harrigan@nshealth. ca or call the physician information line at 1-833-876-1724. Why were there restrictions on where physicians could practise? It was agreed for years that the best service to Nova Scotians would be to ensure doctors worked in areas where they were most needed. However, based on feedback, more flexibility has been added to the process so that family doctors Dr. Lynne Harrigan is vice-presi- dent of medicine and integrated health services for Nova Scotia Health Authority and a general internist in the Annapolis Valley. March 2018 | doctorsNS 23