Members Only | 07.01.19
NAMSS Through the Decades
By Kim Pakney, MAM, CPCS, CPMSM
The 1980s article from the last issue of Synergy talked about so many firsts for our profession and industry. The ‘90s were about putting all that was learned into motion and educating the masses while dealing with even more firsts. In the 1990s, education of the MSP was paramount, and the focus of NAMSS changed.
This decade’s first issue of Overview featured a major article on impaired physicians, physician health status, the aging practitioner, and those who are chemically dependent. Following many of the major lawsuits of the ‘80s, this type of story was not surprising.
These early editions of Overview also introduced a regular column called “The Commissions Corner,” which provided information on new changes to The Joint Commission standards.
During this decade, NAMSS created the annual leadership retreat for state presidents, an educational tradition that continues today. NAMSS Headquarters moved from Chicago to Nashville. It was the home area for our Executive Director Margaret Nicholson. Margaret retired in 1996, and Robert Dengler took the helm, moving the office back to Chicago. He would lead our organization until late 1998 when we moved to Association & Society Management, Inc. (ASMI), a management company in Austin, Texas. Ben White served as our executive director, along with his assistant Shannon Diaz and Amy Blakely, the director of education.
1990 editions of Overview told us medical directors were here to stay, helping hospitals better manage service lines. Physician proctoring was introduced, and I saw the first article on physician leadership orientations.
The National Practitioner Data Bank (NPDB) was in full swing, and everyone was figuring out how to use it, what to report, and when. The carbon copy document that we used back then was time consuming, and there were numerous Overview articles on the NPDB.
With the first issue of 1991 came the first article on credentialing for managed care. The National Committee for Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC) both came into existence in 1990. This first Overview issue also tackled landmark lawsuits of the ‘80s.
Each issue of Overview in the early ‘90s had a theme. Quality was a big focus going into the ‘90s. There was a reference to performance-based reappointment; they were realizing the importance of information required for the annual two-year physician reviews. The first article on centralized credentialing was published, a concept that makes good business sense for budgets and large corporations. It is expensive to individually staff each office with credentialers when a centralized office could help a health system. There are so many large health systems that have moved to this concept, and it can be successful when run well.
Board certifying physicians was being discussed. It wasn’t a requirement back in the ‘90s, and today it is often just the opposite.
The benefits of having a degree in our profession was featured. It was not required back then, but today you can’t be a manager or director without at least a bachelor’s, if not a master’s, degree. Articles were written about managing your office, budgets, and managing money for the department. Today, we are no longer just managing offices — we are leading departments.
I saw the first articles from Hugh Greeley and Michael Callahan, two men who are staples in our industry. In 1992, the first article from Elizabeth “Libby” Snelson on “economic” credentialing was written. We had national law firms that were focusing on medical staff law. Special laws can make a huge difference in how your confidential information is handled.
There were several articles on helping our physician leaders understand quality/risk, the value of incident reporting, and how all of it can tie into privileging and credentialing. The articles introduced the needed partnership between quality and the medical staff.
In September 1992, an Overview article discussed reappointment activity summaries, quality in our business, quality beginning with privileges, and how to put privileges online. This was the first time it all tied together in one publication.
We celebrated the first National Medical Staff Services Awareness Week when on Oct. 29, 1992, President George H. W. Bush proclaimed the week of November 1 National Medical Staff Services Awareness Week.
In early 1993, the first article on temporary privileges, “Risk vs. Reward,” was published. We are still struggling with temporary privileges today, as so many want to use them in lieu of full credentialing.
More firsts in the ‘90s include reappointments for hospital-based/contracted providers and the beginning of the big four contracted services (anesthesia, emergency medicine, pathology, and radiology). Today you can add hospitalists, intensivists, neonatologists, primary care, and more to that list.
Unannounced Joint Commission surveys were revealed, and NAMSS was represented at The Joint Commission (TJC) liaison meetings.
The first article about confidentiality in peer review was written by Kathy Matzka, a well-known consultant in our industry. It was important that peer review was understood, especially as a result of the Health Care Quality Improvement Act (HCQIA) in 1986. Sheryl Davis, our 2008 past president, helped us understand HCQIA, a law that provides protection to physicians in peer review.
Credentialing of allied health professionals (AHPs) was a big education point, as AHPs were gaining ground in the industry. Today, they are needed even more due to the shortage of primary care providers.
In 1995, the first job description for medical staff leadership came to the surface. We need those descriptions today, as we pay many of our leaders based on them. Do the Stark Laws ring a bell? Also, the first article on streamlining the credentialing process was published. Now, so much is automated, but back then snail mail and faxing was all that could be done. Faxing was fairly new and was an incredible time saver.
The CPCS certification was introduced in 1995 at the 19th Annual Conference in Pittsburgh. The Certification Commission unveiled the new designation in response to the need to broaden the recognition and credentialing educational opportunities beyond the traditional hospital setting.
In early 1996, the AMA enhanced their data profile. In addition, team building and team approaches were penned for the medical staff departments, and TJC took a stance on centralized credentialing.
There was a significant article about releasing third-party information, and the first article about sharing information between medical staff and managed care credentialing was published. The internet was here, and some information was now at the MSP’s fingertips. Finding information online is the expectation today. This was also the year that the NAMSS Software Guide was first published, featuring all vendors that had credentialing software for our offices to use.
In 1997, Overview transitioned to monthly publication. Today, our articles are written by volunteers, and NAMSS staff see each edition to publication. Back in the day, it was all volunteers except for the publishing part.
In the February 1997 issue, we saw the first article offering NAMSS CE credits by taking a test after reading a feature article.
We also saw the first article on paperless credentialing. The first article from a Horty Springer attorney was published, the CMSC pins were introduced, and NAMSS won the Addy Award for its conference brochure in 1996. This was also the first year that NAMSS listed the conference vendors.
In 1998, Overview changed its name to Synergy. The first articles about the history of the American Board of Medical Specialties (ABMS) and hospitalists were published. There were several articles about MSPs serving as expert witnesses in court cases, which is a sign of the respect our industry was garnering. We also featured the first article about sexual harassment and medical staff. Times were really changing.
In 1998, our colleague Nancy Goodknecht from Ingham Regional Medical Center in Lansing, Michigan, uncovered an individual who was impersonating a physician. He had never been to the medical school listed on his application. He was licensed in the state of Michigan and held a federal DEA. At her facility they verified all education with the source. As a result of this best practice, the lie was found.
There were articles about using the internet while maintaining privacy/security in the electronic age, medical staff managing IRB meetings, and considering deleting meeting requirements.
The Emergency Medical Treatment and Labor Act (EMTALA) became law in 1986, and the very first article about it for our industry appeared in February 1999. This was similar treatment to that of the 1990 Americans with Disabilities Act (ADA), when the first article about how it applies to physician health appeared in the April 1999 issue.
There was an excellent article written by Sheryl Davis about the United States Drug Enforcement Administration (DEA) and the meaning of the schedules and the DEA number. Also, there were many articles about emerging online technology as well as preparing for Y2K.
Whew, what a decade! Please look forward to the next article on the 2000s, appearing in the September/October issue of Synergy!
This article appeared in the July/August 2019 issue of Synergy.
Kim Pakney, MAM, CPCS, CPMSM, has worked in hospitals and now as an independent consultant for over 20 years. Kim spent much of that time in Alaska, only returning to the lower 48 in August 2013. Kim enjoys spending time with her family, traveling for work and pleasure, and is an avid reader and scrapbooker.