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Medical Doctor Background Checks: A Complete Guide [2022]

physician background check

Physician background checks protect patients and healthcare organizations and must be conducted properly to mitigate against risks.

Hiring qualified and trustworthy physicians in your healthcare organization is important for your patients’ safety and your reputation.

Did you know that a Texas man worked as a medical review officer for 13 years even though he was never licensed as a physician?

Failing to conduct thorough physician background checks can expose your healthcare organization to substantial liability, potential sanctions, and negative publicity.

Based on our extensive experience conducting medical doctor background checks, we’ve written this guide for HR professionals in hospitals and healthcare organizations.

Let’s start now.

Why is it Important To Conduct Background Checks on Physicians?

Hospitals and other types of healthcare organizations check the backgrounds of prospective medical doctors to ensure the safety of their patients and employees.

Thorough background checks help to verify that doctors have the requisite qualifications and licensure and don’t have sanctions, disqualifying criminal convictions, or debarments.

Failing to perform comprehensive physician background checks could result in substantial malpractice liability and the potential loss of the organization’s ability to contract with Medicare and Medicaid.

In-depth background checks of physicians offer the following benefits:

1. Mitigate Risks

Checking the backgrounds of physician candidates helps to identify and exclude providers who have a history of disciplinary sanctions, criminal backgrounds, and license issues that could place your organization and patients at risk.

2. Ensure Regulatory Compliance

Thorough physician background checks help to ensure your hospital complies with all regulatory requirements for healthcare employers when they hire doctors.

3. Ensure Competence

Physician background checks can help to screen out prospective physicians who do not have the required competencies to deliver quality care to patients.

What Shows up on a Medical Doctor Background Check?

What will appear on a physician’s background check will depend on the types of searches you request.

Most healthcare organizations ask for the following types of searches:

  • Identity verification
  • County criminal records search
  • National sex offender registry search
  • National criminal records database search
  • License verification
  • DEA disbarment check
  • Past employment verification
  • Education verification
  • FACIS
  • OIG check
  • SAM check
  • Lab-based drug screen

Here’s what might appear on a few of these reports.

Criminal Records

Checking the criminal history of a potential physician can reveal whether they might have disqualifying convictions.

If a prospective candidate has a criminal record, the following types of information about the conviction will appear:

  • Offense date
  • Nature of offense
  • Offense level (misdemeanor/felony)
  • Disposition of the offense
  • Disposition date
  • Might include sentence information
  • Currently pending criminal cases

If there is an expungement law in your state, any convictions for which the candidate has obtained an expungement won’t be reported.

Medical License Verification

Verifying the medical licenses of both your prospective and current physicians is critical to ensure their licenses remain valid and current and that they have not received any sanctions against their licenses.

State licensing requirements vary, so you should ensure your candidates possess the required licenses for the location in which you are hiring.

A medical license verification shows the following details:

  • Type of medical license
  • Date of issuance
  • Expiration date
  • Sanctions or suspensions
  • License status

If your screening process is inadequate, you might hire an unlicensed doctor and expose your hospital or healthcare organization to substantial liability and reputational damage.

Employment Verification

Verifying the past employment of prospective physicians confirms a candidate’s reported employment history on their curriculum vitae or resume.

An employment verification reveals the following details about each past position held by a candidate:

  • Name and address of each past employer
  • Dates of employment
  • Positions and titles held

Verifying past employment can help to screen out candidates who have been dishonest on their resumes about their work history.

Education Verification

Verifying a candidate’s education history confirms if they have attended the schools and earned the degrees they’ve reported on their resumes.

Education verification shows the following information:

  • Name, address, and location of each educational institution attended
  • Dates of attendance
  • Degrees conferred

Healthcare Sanctions

Healthcare sanctions checks search numerous state and federal databases to determine whether a physician has been sanctioned by state or federal healthcare regulators.

If your organization contracts with Medicare and Medicaid to provide healthcare services, it is unlawful for you to employ sanctioned physicians.

Hiring a sanctioned physician can expose you to severe penalties, including the following:

  • Fines of up to $10,000 for each violation
  • Suspension from your ability to contract with Medicare and Medicaid
  • Potential jail in egregious cases

A healthcare sanctions check will include the following types of searches:

  • Department of Health and Human Services Officer of Inspector General List of Excluded Individuals/Entities (OIG search) – Shows whether a candidate has been excluded from employment with healthcare organizations that receive federal funds
  • General Services Administration System for Award Management Check (SAM check) – Shows whether a candidate has been barred from receiving federal subcontracts or contracts
  • Healthcare fraud and abuse lists – Reports whether a candidate has a sanction history using information from licensing and certification boards in every state and multiple federal agencies
  • State-specific exclusion lists – Shows whether a candidate has been barred from healthcare employment in various states

The Fraud Abuse Control Information System (FACIS) is also used to check for healthcare sanctions.

This is a system comprised of multiple regularly updated databases made up of varying levels of data to ensure that doctors and other healthcare workers have not committed fraud against the state or federal government or abuse against patients under their care.

A FACIS check can include the following three levels:

FACIS Level 1 – OIG, DEA, FDA, Medicare Opt-Out, OFAC-SDN, Tricare, and State debarment and Medicaid sanctions
FACIS Level 2 – All searches from level 1 and additional state information
FACIS Level 3 – All searches from levels 1 and 2 plus data from sanctioning boards in all states and U.S. territories.

A comprehensive healthcare sanctions check can help you avoid inadvertently hiring a sanctioned doctor.

How Far Back Do Physician Background Checks Go?

How far back a physician background check can go depends on state and federal laws.

The Fair Credit Reporting Act (FCRA) is a federal law that places restrictions on how far back certain types of information can be reported on background checks for positions paying less than $75,000 per year.

For positions paying under $75,000 annually, the following information can’t be reported when it is older than seven years:

  • Arrests that didn’t result in convictions
  • Liens
  • Civil judgments
  • Civil lawsuits
  • Bankruptcies

However, since most physician positions offer far more than $75,000 per year, these restrictions likely won’t apply.

The laws of some states also place restrictions on how far back information on background checks can be reported, so you should check with your state to learn more.

In general, information about convictions, education, employment, and other critical data can be reported regardless of how far back it goes.

Most hospitals and healthcare organizations request information for at least the past seven years.

How to Run a Background Check on a Medical Doctor

There are two primary ways to conduct a background check on a medical doctor, including a do-it-yourself background screen or partnering with an experienced background check provider like iprospectcheck.

1. Do-it-Yourself Checks

Some hospitals and healthcare organizations attempt to perform DIY background screens on prospective physicians.

They might check various federal and state lists, check with their state’s medical licensing board, send requests to their state’s criminal repository, and ask for information from medical schools, colleges, employers, residency locations, and more.

If you attempt a DIY approach, the process could take weeks and leave you with inaccurate or incomplete information that doesn’t comply with the FCRA and other relevant laws.

2. Partnering With a Dependable Background Check Provider

The best approach is to partner with a reputable and reliable background check provider like iprospectcheck.

We keep current with all changes to relevant state and federal background check laws to ensure we remain compliant.

We also have access to reliable information sources and use our cutting-edge research skills and technological prowess to quickly return accurate, current, and legally compliant physician background check reports.

Why Partner with iprospectcheck for Physician Background Checks?

Here’s why you should consider selecting our team as your background screening partner.

1. Industry knowledge

Our company was founded by professionals from a healthcare staffing background who were frustrated by inadequate background screening providers.

They created a reliable, technologically superior employment background screening company to meet the needs of healthcare organizations and recruiters.

2. Exceptional service

We prioritize our clients’ needs and the experiences of their candidates by being responsive, fast, and transparent.

Our service team is 100% US-based to protect your confidentiality and meet your requirements.

3. Ensure accuracy and compliance

We stay current with all state, local, and federal laws and regulations to ensure that our reports are fully legally compliant.

We also strive to return 100% accurate reports to our clients so that you can feel confident in your hiring decisions.

4. Innovative technology

We leverage the latest technology to keep your candidates informed throughout the screening process and quickly return reports so that you can make fully informed employment decisions.

5. Data security

At iprospectcheck, our processes are fully secure and use strong encryption to protect the security and confidentiality of your sensitive data.

6. Volume discounts

If your hospital or healthcare organization anticipates ordering 50 or more background checks each year, you can take advantage of our volume discounts to help keep your hiring costs down.

Request Your Free Physician Background Check Quote Today

As a healthcare organization, you want to ensure that your patients receive the highest quality of care from fully qualified and competent physicians.

At iprospectcheck, we have all of the necessary resources, technology, and knowledge to conduct thorough healthcare background checks so that you can make smarter hiring decisions.

Contact iprospectcheck today to learn more about our employment screening and clinical services and receive a free physician background check quote: 888-509-1979

DISCLAIMER: The resources provided here are for educational purposes only and do not constitute legal advice. Consult your counsel if you have legal questions related to your specific practices and compliance with applicable laws.

Know Before You Hire

About the Author
Matthew J. Rodgers

Matthew J. Rodgers

Matthew J. Rodgers is a highly accomplished business executive with over 30 years of experience providing strategic vision and leadership to companies ranging from the fortune 500 to iprospectcheck, a company which he co-founded over a decade ago. Matthew is a valued consultant who is dedicated to helping companies create and implement efficient, cost effective and compliant employment screening programs. Matt has been a member of the Professional Background Screeners Association since 2009 . When not focused on iprospectcheck, he can be found spending time with his family, fly fishing, or occasionally running the wild rivers of the American west. A lifetime member of American Whitewater, Matt is passionate about protecting and restoring America’s whitewater rivers.