Practice Economics

Background Checks


If the hospitalist recruitment process is a puzzle, then the background check is the vacuum cleaner, sweeping the area for any missing puzzle pieces.

“You are trying to get the whole picture,” Tim Lary, vice president of physician staffing at North Hollywood, Calif.-based IPC: The Hospitalist Company, says. “You are trying to see if something doesn’t fit right.”

Any competent healthcare organization will conduct a background check on hospitalist job candidates, first and foremost to ensure patient safety and a safe practice environment for other healthcare providers, Lary says. There also is the issue of liability.

Financial liability for the negative acts of employees, whether accidental or intentional, is an area of exposure for businesses, says Les Rosen, president and CEO of Employment Screening Resources, a consumer reporting agency and human resources consulting firm in Novato, Calif. Businesses can be held liable for injuries resulting from the failure to adequately screen the people it hires. Background checks demonstrate the organization has done its due diligence in assessing the safety and competence of job candidates.

“It enables an organization to hire based upon facts, not just instincts,” Rosen says.

How to Prepare for a Background Check

  • Check court and motor vehicle records to make sure they are correct and up to date.
  • Inform job references and work colleagues that they might be contacted.
  • Get a copy of your credit report, and contact creditors and/or the credit bureau about any information you disagree with or don’t recognize.
  • Request to see your personnel files from old jobs.
  • Remove or edit offensive or unflattering material on your social networking web pages and/or blogs.
  • Hire a company to do a background check on yourself to see if databases contain misleading or inaccurate information.

Source: Privacy Rights Clearinghouse

Background Basics

Hospitalists must be prepared to effectively deal with background checks throughout their professional careers. Employment checks often involve three areas: credentials verification, reference checking, and an additional background investigation.

Credentialing includes a review of the hospitalist’s completed education, training, residency, licenses, and any certifications, and often encompasses the candidate’s hospital privileges history, malpractice claims history, and peer reviews.

Reference checking involves verifying dates of employment and title at the hospitalist’s previous jobs, and contacting references to speak with them about the candidate’s qualifications.

Background investigations often are done by a third-party agency. The investigation will vary depending on the policies of the healthcare organization contracting the review, but, generally speaking, it includes a check of the following:

  • Criminal and civil court records for criminal convictions, arrests, and lawsuits;
  • Motor vehicle records and driver record status;
  • The National Practitioner Data Bank for malpractice cases and medical board sanctions;
  • Medicare sanction list of the Office of Inspector General in the U.S. Department of Health and Human Services;
  • Social Security number; and
  • Sex offender and terrorist databases.

Some investigations will include credit checks, which can cover credit payment history, bankruptcies, tax liens, and accounts placed into collections.

It is illegal during a background check to search for information related to a job candidate’s race, age, religion, sexual orientation, or any other protected category under the federal Civil Rights Act, says Cheryl Slack, vice president of human resources at Brentwood, Tenn.-based Cogent Healthcare.

Under the federal Fair Credit Reporting Act (, it also is illegal for a third-party consumer-reporting agency to perform an employment background check in secret, Rosen says. The applicant must authorize the check by signing a standalone disclosure form, he says. For the rare healthcare organizations that do their background checks in-house, most will seek consent.

Disclosure Is Crucial

Hospitalist job candidates should do whatever they can to make sure the people in charge of hiring aren’t surprised by what turns up in a background check, the experts say. “Nothing is more frustrating than finding out there is a problem late in the application process,” Lary says.

Hospitalists should inform the references they list on their resumes that they could be contacted. Such a “heads up” often gives a reference time to organize their thoughts about the job applicant and provide the best possible recommendation.

“You would be shocked at how many references are surprised to learn the hospitalist is looking for a job or how many applicants give as references people who don’t like them personally or professionally,” Lary says. “There are even times when physicians will take a pass on a reference. That speaks volumes.”

The most important thing a candidate should know is if there is something negative in their background that could be professionally damaging if discovered. It is best to make the people hiring aware of the information, Rosen says.

“Disclosure is best 100% of the time,” says Reuben Tovar, MD, chairman of Hospital Internists of Austin, a physician-owned and -managed hospitalist practice in Texas. “To deny or not include something on a resume or in an interview makes it look like you are a liar, or haven’t come to terms with what happened.”

The main impediment to disclosure is embarrassment and shame, says Dr. Tovar, who has encountered a number of physician candidates who have had problems. Those who disclose past issues are in a much better position to explain the situation and show how they have cleaned up a messy situation.

“Physicians are generally willing to at least consider giving their colleagues a second chance in employment and [hospital] credentialing if they are forthright,” Dr. Tovar says. “Not being forthright is an automatic exclusion.” TH

Lisa Ryan is a freelance writer based in New Jersey.

Background CHECK Fundamentals

Question: Do you have the right to know when an employment background check is done?

Answer: Yes, if the background check is conducted by a third-party agency on behalf of the employer. The employer must obtain your consent in writing before the background check is performed.

Q: Can an employer check your credit as a condition of employment?

A: Yes, but the credit report won’t include a credit score. It will include information about credit payment history and other credit habits. It should be noted that many human resources professionals are reluctant to do credit reports unless it is relevant to the job. Some states (Oregon, Washington, and Hawaii) have restrictions.

Q: Will background checks include old criminal convictions or arrest records?

A: Criminal convictions can be reported indefinitely under federal law. The state you live in might offer more protection. The Fair Credit Reporting Act does not allow screening agencies to report an arrest that happened more than seven years ago. However, the rule doesn’t apply to jobs paying $75,000 or more.

Q: Can a background check include medical information?

A: Medical information requires your written consent and must be relevant to employment.

Q: Are you entitled to a copy of your background check?

A: Yes. When an employer informs you that a background check will be done, ask for the name of the screening agency. Contact the company and request a free copy of the report.

Q: What can you do if the information in the background check is erroneous?

A: Submit a written dispute with the company that conducted the screening. The company must investigate your claim and provide you with written results of what they find. Also, take steps to fix the inaccuracy at the source (i.e. court or credit issuer) so the same incorrect information doesn’t surface if another agency conducts a check.

Sources: Fair Credit Reporting Act, Privacy Rights Clearinghouse, Employment Screening Resources, Cogent Healthcare

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