Colorado remains one of a handful of states that does not require its state medical board to conduct criminal background checks on doctors when issuing licenses. However, a recent report by The Denver Post is calling attention to the matter, which has the potential to affect legislature in the upcoming session.
Current state law requires medical license applicants to list, in detail, past convictions on their application with the Colorado Medical Board. Once licensed, doctors are required to self-report subsequent convictions. However, The Denver Post looked at a handful of cases whereby doctors with a criminal history in other states received a license to practice medicine in Colorado. Some of the cases that they looked at included doctors charged with chronic drunk driving, Medicaid and Medicare fraud, and drug abuse.
So who is to blame? The paper paints the picture of numerous departments and organizations dropping the ball, but does not explain the hardship of building uniformity across competing regulators (of which I learned more by reading about it in the comments). The paper notes that complaints made against doctors to hospitals and/or police are not automatically reported to the medical board; instead, it appears to be a manual process. The cases that The Denver Post wrote about appear to have only resulted in disciplinary action.
For about 18 years, the Federation of State Medical Boards has recommended – but not required – that state medical boards conduct criminal background checks on physicians seeking full or partial licensure.
“Criminal background checks are a valuable tool for state medical boards in detecting applicants for licensure with criminal backgrounds that could endanger patients within a state,” said Lisa Robin, chief advocacy officer for the FSMB. “However, state boards must have statutory authority from their state legislature in order to conduct background checks on applicants for licensure.”
Cory Everett, a spokesperson for the Colorado Division of Professions and Occupations, made an important note about the state’s current approach to the background checks:
“Although the state does not conduct criminal background checks on those seeking a medical license or on licensees, it does annually check licensee names against the Colorado Sex Offender Registry. Officials in that division also rely on a national database that tracks adverse licensing of doctors from participating states. Law enforcement and state licensing officials also often collaborate when criminal allegations are made. We again would reiterate that the medical board and the division of professions and occupations cannot create law. We may only enforce the law as written. The Colorado General Assembly, unlike most state legislatures, has declined to adopt laws allowing fingerprint background checks for physicians.”
The criminal background check process can be expensive, time consuming, and burdensome. Fingerprints must be taken professionally by an experienced individual and the criminal history searched across various databases. If required, who should pay for the costs? At what point during the licensure process should background check be conducted? How frequently should the checks be updated – annually, bi-annually, or more or less frequently? Who should cover the cost for subsequent checks? Should individuals go through the same entity to conduct all background checks, or can doctors purchase a background check from the provider of their choice and submit that to the medical board? Hopefully, other states have best practices from which Colorado could learn and adopt.
It is worth noting that just because the medical board does not require these two safeguards, it does not mean other entities, such as insurers or credentialing companies, do not require them in their vetting process. Each entity has their own set of guidelines in managing liability and accountability, and some are comfortable accepting the minimum requirements, whereas others enforce guidelines that are more stringent.
Proponents for more oversight say they want to ensure the doctors entrusted with providing medical care are free of criminal backgrounds, and for this, help may be on the way. In Colorado’s next legislative session, State Rep. Susan Lontine plans to introduce a bill requiring background checks for doctors. She successfully co-sponsored a similar bill this year that requires the background checks for surgical technicians and surgical assistants. Such a measure could help flag criminal convictions in the application process, but unfortunately, those wishing to circumvent the law usually find a way to do so for their benefit.