Showing posts with label credentialing process. Show all posts
Showing posts with label credentialing process. Show all posts

Wednesday, October 26, 2022

Safety Practices for LAcs: The Autumn 2022 Presentations from the HHP's Safety Practices Workgroup (Sept, Oct, Nov.)



HHP is the nonprofit collaborative learning network for healthcare system-based LAcs and program managers.

We are the home of the healthcare system-based acupuncturist community network

Help us keep the HHP's work going this year (2022) and into 2023.





Safety Practices for LAcs, a new set of resources from the HHP

Updates on this past year’s progress with the HHP’s Safety in Practice Workgroup


For the latest information on this workgroup and its work, from presentations to publications, go to these pages on the HHP's website:

Safety Practices for LAcs, an article getting updated with event info Sept - Nov 2022.

September public presentation, the event page.

October public presentation at the IM4US 2022 conference, "Speaking the Language of Safety in HROs for LAcs." The presentation landing page.



November 12th, 2022, "Introduction to Safety Practices for LAcs in Healthcare System Practice. For Acupuncturist clinicians, safety leads, and program managers." public presentation, the event page.


The Hospital Handbook Project for Acupuncturists and Their Hospital Sponsors is a program of Free Range Health®, a 501(c)(3) public charity. All or part of your donation may be tax-deductible as a charitable contribution. Please consult with your tax advisor. Federal Tax ID #45-4395933

Sunday, June 24, 2018

What is the National Databank for Healthcare Providers and How is it Relevant to Hospital-based Practice?

keywords:  resources, basics, the national provider database for health care practitioners, hospital-based practice, credentialing process
https://www.npdb.hrsa.gov/

NPDB = national practitioner data bank
This gets queried by the credentialing department when you have applied to a job and your paperwork is "processing".  Along with a state criminal background check, the NPDB data bank is also checked.  As a practitioner, you can do a self-query so you understand what data is being reported about you in this national data bank.

Learn more at the U.S. government website, run by the Department of Health and Human Services (HHS).

For more about the credentialing process for integrative health practitioners, check out these related posts:



https://www.npdb.hrsa.gov/

https://www.npdb.hrsa.gov/


Sunday, February 25, 2018

The BLS Standard Occupational Code for Acupuncturists


keywords:  occupational code, SOC, hospital credentialing, profession tracking, issues in student loan repayment, the development of a profession, why and how a federal occupational code (SOC) makes a difference for a profession


Did you know, that, for the first time in our profession, we have a unique Standard Occupational Code (SOC), published and being tracked by the Bureau of Labor and Statistics since Jan. 1st, 2018?


This is a major milestone for our profession.

29-1291 Acupuncturist


Two other major milestones for hospital-practice Acupuncturists have occurred within just 40 days of this.

  1. The Joint Commission Pain Management Standard began official implementation Jan. 1st, 2018 for any accredited facility (most U.S. hospitals strive for accreditation by the Joint Commission).  This includes requiring facilities to provide non-pharmacological pain management therapies (such as acupuncture/East Asian medicine, chiropractic, yoga, physical therapy, health psychology) by qualified, licensed practitioners. 
  2. The VA Occupation/Staffing Handbook was updated February 7th, 2018 to include a professional occupation distinction, Acupuncturist.

So, how does having a standard occupational code (SOC) make a difference?

In my experience, this makes a difference in at least 2 ways:

  1. Potential for the profession to be eligible and included as in federal student loan forgiveness programs
  2. Makes it easier for health care organizations to create job descriptions and credentialing packets for your occupation.  
    1. So, if you are the first or one of the first people in your profession to work in that health care facility, civilian OR federal, the facility now has this basic standard that they are accustomed to reference, the BLS SOC Handbook, to write the basic outline for the job (position) description and the outline for your credentialing packet.



Storytime
Time period:  2006 - 2010
Hospital Credentialing Office:  What is the occupational code for your profession? 
Me, as a volunteer in the early 2000s:  I don't know.  Let me find out.   
Calling my mentors and national organizations:  What is our occupational code?
...crickets...then, 
Someone in the NCCAOM® office:  Actually, we are working on it. 
Me:  Cool.  What does that mean? 
NCCAOM®:  It's complicated.
[Check out all of NCCAOM® (staff and volunteers) work on how they worked on this process over the past decade or so on their webpage
Me, to the Credentialing office in the early 2000s:  My profession does not have a specific BLS federal occupational code at this time. Here are some related standards and the current update on the process. 
Hospital Credentialing Office:  [that dreading look of "this means I have to pull together something from scratch"].  Do you have any examples of how Acupuncturists have been credentialed at other facilities? 
Me, calling the few contacts I had at hospitals Can you share with my facility a copy of what your credentialing department? 
Answers:  "no, this is proprietary information".  "yes, we would love to!"

Fast-forward to 2018:
Hospital Sponsor/Credentialing office:  What is your occupational code?
Acupuncturist:  29-1291 Acupuncturist.
Hospital Sponsor/Credentialing office:  Thank you.  Do you have any examples you can share of other facilities' credentialing standards for your profession?
Acupuncturist:  Yes.

  1. Here is the VA's published occupation staffing code for Acupuncturists, published in Feb. 2018
  1. Here are my national organization, NCCAOM® Hospital-based Task Force guidelines on credentialing documents, published in 2016, link updated May 2019:
  • "Credentialing of Acupuncturists for Hospital-based Practice:  A Resource Guide for NCCAOM® Diplomates".  July 2016.
  • "Credentialing Licensed Acupuncture and Oriental Medicine Professionals for Practice in Healthcare Organizations:  An Overview and Guidance for Hospital Administrators, Acupuncturists and Educators".  October 2016. 



...end of storytime...


Where can I find the federal BLS Occupational Code Manual to revel at the code, finally published?

Go to the Standard Occupational Code (SOC) webpage on the U.S. Bureau of Labor and Statistics website and follow the links to the 2018 Manual  

You can view a pdf of the 2018 Manual from here.  For the published occupational code listing for Acupuncturist, go to p. 107 in the document (114 in the pdf).  This Manual has been officially in use since Jan. 1st, 2018.  




References
The 2018 Standard Occupational Code (SOC) Manual
The NCCAOM® multi-year work on the SOC for Acupuncturists
The Joint Commission Pain Management Standard Clarification
Publications:  Hospital-based Task Force papers and Recognition of Acupuncturist as Licensed Independent Practitioner (LIP)

Related Blogposts
The VA Occupational Code for Acupuncturists
Why this Project?  Megan's story

Want to learn more on documenting clinical change in your patient-centered practice? 
Check out our Metrics series posts: The Pain Scale and Medication Review:  Calculating Morphine Equivalent Dose (MEQ).

If you have found this blogpost useful, support this work through a cup of coffee 
or more at our website.  
Thank you. 


Follow us on our public Facebook page and sign up for newsletters and announcements through our website.  See you there!

Sunday, February 18, 2018

The VA Occupational Code for Licensed Acupuncturists

The VA Occupational Code for Licensed Acupuncturists has been published!

Thank you to everyone involved in the process who kept doing that next right thing over the past several years to build this code through what must be a tedious process.  This occupational code is a huge step toward making this non-drug and non-surgery integrative health resource available to patients as part of their VA care from the local VA clinic to the larger medical centers.  From a practitioner perspective, this is big step in the ability to be a full employee instead of temporary contract positions.

For more practitioner resources about how to work in hospital practice, connect to our community here and help us build and grow resources for current and future practitioners.  We endeavor to fix the silo problem by creating community.  Learn more about why I founded the Project here.

For hospital administrator resources on how to hire and credential Acupuncturists, there are some basic guidelines here, published by the national organization NCCAOMⓇ and more resources being created through this Hospital-Practice Handbook Project.  

If you are hiring a new practitioner not already connected to the community, please connect them to our contact page and Facebook page where they can connect to other hospital-practice Acupuncturists.  "We connect, share wisdom" to help avoid re-inventing the wheel.  For more about why I launched this project, watch this short video.

Now for the weblink you have been waiting for!

Go to this page


Then, scroll down to the line for Acupuncturist:
5005/100
Staffing--Acupuncturist
02/07/2018



and it brings up a pdf with a note that the pdf or VA Handbook update was published 2.7.2018.

Let's see that screenshot again (I am so happy!):


























Looking at the online pdf, it looks like the positions are title 38 hybrid status and the range of  GS-9 (which reads like an internship position) to GS-11 and GS-12 as full-practitioner and GS-13.  GS-13 are supervisor or program coordinator positions.  It is not clear to me what a full-time researcher position would be, but perhaps that is covered in a different category (the research job category?) of job positions than this.


Wonderful news!  Thank you to everyone who worked on this effort!!
Blessings.
Megan

Are you a civilian (non-veteran)?
If you are a civilian interested in working with veterans or military families, here are some basic resources to learn more about and respectful toward our culture: 


Related Blogposts
Why This Project? Megan's story
Fixing the Silo Problem:  How the Project is Working to Create Community and Build Resources
Supporting Our Hospital Sponsors/Hospital Administrators
Creating Connections, Growing Community
Why Build This Resource?
The Webinar Series Project, ready for funding  :)

Want to learn more on documenting clinical change in your patient-centered practice? 
Check out our Metrics series posts: The Pain Scale and Medication Review:  Calculating Morphine Equivalent Dose (MEQ).

Follow us on our public Facebook page and sign up for newsletters and announcements through our website.  See you there!

Wednesday, July 27, 2016

National Practitioner Databank

keywords:  credentialing and privileging process, hospital employment, new hire, hospital practice, malpractice insurance, adverse events

The National Practitioner Databank (NPDB) and the credentialing process

What is the NPDB?
The National Practitioner Databank tracks info on health care providers including malpractice insurance and reported adverse events.  It is standard practice in the process of hiring and credentialing a health care practitioner at a hospital to query the NPDB.  Just as background checks are standard practice.

How does it relate to or affect you?
Every health care provider who works in a medical center has an entry as a practitioner in the NPDB.
You can learn more about it and see an infographic at the NPDB website.  If you want to see what your entry looks like or if you have an adverse report, you can do a self-query.

There used to be two data banks which credentialers would have to check for a health care practitioner, the NPDB and the HIPDB.  As of May 2013, the HIPDB has been rolled into the NPDB to streamline the databank and query process.

related:  HIPDB

Saturday, May 7, 2016

The Acupuncturist Occupational Code FAQs

keywords:  credentialing, hospital employment, national standards

Q:  Do Acupuncturists have a federal occupational code?  What is it?
Yes.  29-1291-Acupuncturist

Q:  When is the BLS occupational code finalized?  Is it useful for hospitals before it is finalized?
2018 and Yes.

The Acupuncturist Occupational Code, as tracked by the U.S. Bureau of Labor and Statistics (BLS) is not finalized until 2018.  The electronic print edition of the BLS's Standard Occupational Classification (SOC) handbook is scheduled to be published in summer 2017.

What is great about BLS and O*Net is that you can look online (O*NET) and see the final, detailed draft of the code.  I have heard from various hospital credentialing experts from as early as 2012 that this info, even while not “finalized” is useful info for them.  It writes their credentialing packet for them, in essence.  

While we wait this last year for the code to be finalized, it is good to know how useful just the final published draft of the occupational code is to credentialing experts and those who write position descriptions (job descriptions).

I have written more about the Acupuncturist occupational code and how it relates to hospital practice in the fall issue of Meridians, "Hospital Practice:  Recognition of Acupuncturist as a Licensed Independent Practitioner (LIP)".

Gale M, Hospital Practice:  Recognition of Acupuncturist as a Licensed Independent Practitioner (LIP).  Meridians:  JAOM, 2016 3(4):  11-16, 41.

NCCAOM has lead the way in the creation of the occupational code.  See their website for the latest update.

Wednesday, May 4, 2016

What is a National Provider Identifier (NPI)?

key words:  hospital practice, employment, NPI, HIPAA, insurance, Medicare and Medicaid (CMS), LIP

The National Provider Identifier (NPI) is a standard through the HIPAA (Health Insurance Portability and Accountability Act) Administrative Simplification Standard.

Remember the goal of HIPAA was (and is) to standardize and simplify the insurance processing system.

NPIs are issued to U.S. healthcare practitioners by the Centers for Medicare and Medicaid Services (CMS).  The CMS website explains that, "The NPI is a unique identification number for covered health care providers [who, along with all plans or companies who provide health care insurance] must use the NPIs in the administrative and financial transactions adopted under HIPAA.  The NPI is a 10-position, intelligence-free numeric identifier."

While an NPI is required to bill insurance, every LIP should have an NPI, even if you never plan to bill or take insurance.  It costs nothing and is an easy registration process.

You cannot work at a hospital without an NPI.  It is a standard requirement as part of employee paperwork.  To register for an NPI, go to the NPPES (National Plan & Provider Enumeration System) site.  The site has references to the related standard in the federal HIPAA rule.

For more on these terms, see related posts:
HIPAA

References:

U.S. Public Law, the Patient Protection and Affordable Care Act.  Officially:  Public Law 111–148 111th Congress.  Currently dated March 23rd, 2010.  Length of document on pdf:  906 pages.


The implementation of this federal law is often called:  “The Affordable Healthcare Act (ACA)” or “ObamaCare”

Monday, January 11, 2016

Acupuncturists are LIPs and how that affects how to hire and credential them

updated 7.27.2016


keywords:  LIPs, credentialing, privileging, Joint Commission, NPI, CMS

Acupuncturists and LIP status.
Licensed Acupuncturists (L.Ac.) are Licensed Independent Practitioners (LIPs), and recognized as such in 43 states and the District of Columbia.
LIP is a legal term.  It is affected by and related to state licensing law (scope of practice by state).  It is defined by The Joint Commission. 
According to HIPAA (which is about insurance payment and coding streamlining and privacy protection), all LIPs must carry an NPI.   An NPI (national provider identifier) is used to track insurance claims.  When you are filling out employment paperwork at a hospital, you submit them your NPI (among many other forms).
The definition of NPI by CMS (Center for Medicaid/Medicare), “the NPI is a unique identification number for covered health care providers [who, along with all plans or companies who provide health care insurance] must use the NPIs in the administrative and financial transactions adopted under HIPAA.  The NPI is a 10-position, intelligence-free numeric identifier.”  [see related blogpost on NPI.]

Licensed Independent Practitioners (LIPs) and The Joint Commission (TJC)
The Joint Commission (TJC) and LIP.  TJC’s document, The Who, What, When, and Where’s of Credentialing and Privileging discusses the particulars of said process.  Related to L.Ac.s, we look at how they treat LIPs (since we are LIPs).  “An ‘LIP’ is a licensed independent practitioner, defined as an individual, as permitted by law and regulation, and also by the organization, to provide care and services without direction or supervision within the scope of the individual’s license and consistent with the privileges granted by the organization.”

Credentialing as a vetting process for a new hire.
Credentialing, is a vetting process, as a hospital admin colleague of mine explains.  In fact, going back to page 2 of TJC’s Who, What, When, Where document, under “credentialing”:  Credentialing is the process of obtaining, verifying, and assessing the qualifications of a practitioner to provide care or services in or for a health care organization. Credentials are documented evidence of licensure, education, training, experience, or other qualifications. Examples of credentials are a certificate, letter, or experience that qualifies somebody to do something. They can be a letter, badge, or other official identification that confirms somebody’s position or status. Your organization obtains primary source verification of the LIP’s education, training, certificates and licensure from the primary source, and maintains the file of information.


Credentialing of LIPs as medical staff appointments
Medical and dental staff appointments are a traditional in some hospital systems.  All staff appointments are LIPs.  But not all LIPs qualify for medical or dental staff appointment.  Every hospital system that has this tradition of medical staff appointments has related qualification standards.  For example, some centers state only full-time employee LIPs are eligible for staff appointment (not part-time).  Check your local medical facility for what their written medical appointment qualifying standards are.

Review 
Generally, the LIP recognition is what we go for when looking to be hired at an institution.  We are LIPs; start here.  

References

Definitions
L.Ac.--  Licensed Acupuncturist, the most common state license title 
LIP--Licensed Independent Practitioner
HIPAA--Health Insurance Portability and Accountability Act
NPI--national provider identifier
CMS--Centers for Medicare and Medicaid Services  www.cms.gov

TJC--The Joint Commission, an independent non-profit entity that accredits and certifies healthcare facilities and programs; a major quality assurance entity.

For more thorough information on this topic, read my article in Meridians,
Gale M, Hospital Practice:  Recognition of Acupuncturist as a Licensed Independent Practitioner (LIP).  Meridians:  JAOM, 2016 3(4) (accepted for publication).

related blogposts:

Thursday, November 12, 2015

Credentialing and Privileging, part 9: Temporary privileges

keywords:  credentialing, privileging, temporary privileges, telemedicine

So far, what I am understanding from these resources is that temporary privileges are commonly granted in the following cases:
disaster relief scenarios
telemedicine and telehealth consultations
any time medical facility has an "urgent need" to deliver "necessary care" to the patient.


Temporary privileging, more reading: 
Joint Commission reference p. 6
A 2010 article from HC-Pro explains "expedited credentialing" vs. granting temporary privileges.

2015 article on pros and cons of temporary privileges.  Temporary privileges most common in disaster relief conditions and for telemedicine consultation. The author looks at TJC guidelines and CMS interpretation of guidelines and refers you back to your state hospital organization for direction.  


Credentialing and Privileging part 8: Joint Commission references

Joint Commission References on Credentialing and Privileging
original post 2015.11.12, revised 2016.08.29

Keywords:  credentialing, privileging, Joint Commission, licensed independent provider (LIP)


Joint Commission standards on independent providers, credentialing, and privileging:
The Joint Commission (TJC) is the authority on credentialing and privileging guidelines for all U.S. hospital and healthcare systems:   
“An ‘LIP’ is a licensed independent practitioner, defined as an individual, as permitted by law and regulation, and also by the organization, to provide care and services without direction or supervision within the scope of the individual’s license and consistent with the privileges granted by the organization” [TJC’s The Who, What, When, and Where’s of Credentialing and Privileging]


The Joint Commission's Guideline:  Who/What/When/Where of Credentialing 
**great resource**
This resource quoted above, its full title is The Joint Commission Ambulatory Care Program:  The Who, What, When, and Where's of Credentialing and Privileging.  It reviews the basic guidelines for credentialing and privileging health care providers.

Credentialing and Privileging, implementing a process.  Joint Commission blogpost March 12th, 2012, Virginia McCollum, "Credentialing and Privileging-Implementing a process", Ambulatory Buzz.  This blogpost outlines the basics for understanding the credentialing process for an LIP from a TJC leader's perspective.

"Getting to the Heart of Credentialing and Privileging", an April 23rd, 2014, Ambulatory Buzz blogpost written by TJC ambulatory surveyors, Susan Herrold, MN, RN and Mary Pat Hall, MSN, RN, sharing their viewpoint and advice on the process.

More reading:
HH Blogpost that discusses OPPE and FPPE more
Here is a link to the Joint Commission blog
HH blogpost on temporary privileges


Monday, October 5, 2015

Credentialing and Privileging Process part 3, FPPE, OPPE, and Peer Review

Credentialing, Privileging, and Professional Practice Evaluation (FPPE and OPPE)

updated 8.26.2016
Keywords:  credentialing, privileging, FPPE, OPPE, quality assurance, peer review, LIP
Related posts:  Credentialing and Privileging section
For updates in practice and/or a consultation, contact us via the website.

In credentialing and privileging Licensed Independent Practitioners (LIP), The Joint Commission (TJC) established the following quality assurance processes, “Focused Professional Practice Evaluation (FPPE)” and “Ongoing Professional Practice Evaluation (OPPE)”[i].  FPPE is the process a new hospital hire goes through the first year or so of practice.  This is commonly a more detailed and thorough vetting and review process than OPPE.  After the FPPE is complete and the practitioner is no longer “new”, commonly OPPE is used as a professional review and quality assurance measure. [Note that FPPE is always used for a new hospital hire.  It may also be used again (on an established hire) if a practitioner is flagged as performing substandard care.]  

FPPE and OPPE basic guidelines are set by TJC.  Every hospital has specific institution-specific versions of FPPE and OPPE for any provider that falls into the Licensed Independent Practitioner (LIP) category of provider-type.  These institution-specific guidelines follow TJC standards.  [TJC Standards Search page[ii]]  OPPE may include any of the following, as determined by the institution:  periodic chart review, direct observation, monitoring of diagnostic treatment and techniques, possible discussions with consulting providers, nursing personnel, and administrative personnel[iii]

Peer Record Review (periodic chart review by a peer or peers) is a common practice for quality assurance and falls under the requirements that fulfill both FPPE (new hospital hire) and OPPE (established hospital employee).

If you are interested in commenting on a TJC standard: 
“The Joint Commission provides a Standards Online Submission Form as one of the means of soliciting questions about the standards.”  TJC invites providers to use the form and send them your questions and thoughts about the standards in their “how to comment on a standard” webpage: and directed to the TJC Standards Interpretation Group through the online standards question form.

Remember, when TJC looks at creating a standard, they judge it by the following criteria:

  • Does it have a strong evidence-base?
  • Does it have a strong relationship to patient outcomes/clinical care?
  • Does it support a health care organization’s goal of patient safety and quality of care?
  • Does it have benefits that outweigh the costs?
  • Does it support a health care priority which impacts quality and safety?


References  



[i] In 2004 The Joint Commission (TJC) renamed “Peer Review” as “Focused Review of Practitioner Performance” and since 2007, it has been known as “Focused Professional Practice Evaluation (FPPE)” and “Ongoing Professional Practice Evaluation (OPPE)”. 
[ii] From Standards page, search keyword “OPPE”.  Under “Hospital and Hospital Clinics” category, then OPPE-Intent.  “The intent of OPPE allows the Hospital/Critical Access Hospital to identify professional practice trends that impact the quality of care and patient safety as it relates to privileges granted to the Licensed Independent Practitioners.”
[iii] From Standards page, keyword “OPPE”.  Under the “Hospital and Hospital Clinics” category, then OPPE-data collection guides
[iv] From Standards page, keyword “FPPE”.  Under the “Hospital and Hospital Clinics” category, note the following links for FPPE:
Components of Design Process
Monitoring Timeline
*Intent*
New Privileges
Pre-defined Process
*4 Required Components*
Peer Review

Links for OPPE:
Low volume practitioners—data use from another organization
Medical/cognitive specialties
*data collection guides*
*Intent*

Wednesday, September 30, 2015

L.Ac. Occupational Code Comparison Chart, demonstrating most similar to privileged provider professions

keywords:  privileging, credentialing, LIP status, occupational codes
related blogposts:
LIP status and Acupuncturists and related Meridians article
Acupuncturist Occupational Code
Credentialing, privileging, and professional practice evaluation (FPPE, OPPE)

Provider type status (when credentialing and granting privileges) for 
East Asian Medicine Practitioners/Licensed Acupuncturists (L.Ac.s):
U.S. Department of Labor Occupational Codes Comparison Chart
2015 revision

This chart compares the following professions:
Physician (MD, DO), Advanced Registered Nurse Practitioner (ARNP), Licensed Acupuncturist (LAc), Physical Therapist (PT), Chiropractor (DC), Clinical pharmacist (PharmD), Physician Assistant (PA), Ultrasound technician, and Physical Therapy assistant.

The chart compares the following factors:
minimum degree required to practice
duration of training
federal occupational code:  delineation, job zone, core tasks
Licensed Independent Provider (LIP) status:  has NPI?  need supervision?
Note:  Chart does not fit well on blogpost at this time.  Contact this blog's editor for a copy.


Source:  O*Net, the Bureau of Labor and Statistics’ tracking system for new professions in the U.S. and
The Bureau of Labor and Statistics’ Occupational Code Handbook

Foot note 1 = “Level 1” vs. “Level 2” privileged provider exists within the U.S. military (DoD) medical system, when credentialing providers.  “Level 1 privileged provider status” in CHCS and AHLTA is allowed only for MDs and DOs.  All other privileged providers fall under “Level 2 privileged providers” in the U.S. military medical system.  In the civilian system, there is no “level” distinction among privileged providers.  In the civilian system, providers are “privileged” if they practice independently or not privileged.  Technicians are not privileged providers.

Friday, September 25, 2015

Explaining Credentialing and Privileging Process in the Hospital part 1

keywords:  credentialing, privileging, Joint Commission, LIP

related blogposts:  recognition of L.Ac.s as LIP, traditions of credentialing and privileging, the tradition of “medical staff” designation


Please see previous post: 
Semantics: Explaining Credentialing, Privileging, and the Licensed Independent Practitioner from May 2015

covers the following topics:
Basic credentialing and privileging terminology
LIP
Review
Fictional example of the credentialing process and privileging process



The Sponsor Issue--Acupuncturists and their Hospital Sponsor

The Hospital Sponsor issue
revised and updated 12.08.2015

keywords: credentialing, privileging, hospital admin, PCMs, peer record review, supervision, licensed independent practitioner (LIP), ACAOM-accredited programs

related topics:  dual-licensees, professional practice evaluation (FPPE, OPPE, peer record review), recognition as an LIP


The Ideal Hospital Sponsor Relationship for an L.Ac.

To get started in a hospital, it has been the experience of successful hospital-practice L.Ac.s to date that they need a Sponsor.

A sponsor is a hospital physician, already established at your medical center, who is willing to support you to be hired.  This person advocates for you through the credentialing process.  This may even be the same person who writes your position description (job duties).  The Sponsor takes on responsibility for you and your potential for better or worse. 

The sponsor understands hospital culture, navigates it easily, and protects you from the political intricacies while mentoring you to work within it.

Ideally, you have more than just your Sponsor who advocates for you at your hospital.  It is your job to make your Sponsor’s “advocacy” as easy as possible.

Eventually, the ideal is that the hospital will see what a wonderful asset you and your medicine are and more L.Ac. providers will be hired and incorporated in more departments and areas of patient care and admin and research.  And someday, enough that an Acupuncture/EAM department may be useful, if such is the case that the hospital is large enough to have physical therapy department or a psychology/behavioral health department.


How are Hospital Sponsors/Advocates grown or cultivated?

Unknown.  There is a wide variety of examples.

However, one common thread I hear through all these shared stories and experiences is that they (sponsors) believe in what we do.  Usually through personal experience or from hearing and seeing positive feedback and results from patients who receive care from an East Asian Medicine Practitioner/Acupuncturist.

Some physicians have also taken a medical acupuncture course or auriculotherapy course.  This is not, however, the majority.

A small number of sponsors are also L.Ac.s.  These are our rare MD-L.Ac.s or DO-L.Ac.s or ARNP-L.Ac.s.  For easier terminology, I will call them “dual-licensed L.Ac.s”.


Peer Record Review, LIP, and the Sponsor

L.Ac.s, as licensed independent practitioners (LIP), require only administrative supervision, not practice supervision.  L.Ac.s can, by education and training standards, receive practice supervision from someone of the same level of ACAOM-accredited education, another L.Ac.  This is consistent with being an LIP.  LIPs, in the hospital setting, must participate in peer record review, a professional performance evaluation standard (FPPE/OPPE).  If an L.Ac. is the only L.Ac. at a facility, this is a challenge.  See related posts on Who supervises the work of an AcupuncturistPeer Record ReviewOccupational Code, and the Meridians article.  

The Sponsor, if he is a dual-license L.Ac., could also be the peer reviewer, by virtue of his ACAOM-accredited training and L.Ac. licensing.  This would be a work-around until more L.Ac.s could be hired.  See Dual-licensee post for more information.

Example of Hospital Sponsor relationship

A PCM with a medical staff appointment (usually a physician) at a medical center takes an interest in wanting to hire an L.Ac.   This person will hereon be called the “hospital sponsor”. This usually comes from one (or more) of the following motivators:

  • Interest in non-drug pain management options (possible push from Joint Commission’s standard if med center has a pain management program)
  • Interest in integrative medical therapies
  • Has had patients request Integrative Medicine (IM) therapies, particularly acupuncture, and is interested in bringing related staff on-board as employees to help fill the need and patient requests
  • Is interested in a PCMH model that incorporates IM
  • The state’s interpretation of the Affordable Health Care Act includes insurance coverage of acupuncture as practiced by L.Ac.s  [affordable health care act post/worker’s comp coverage of acupuncture post]  
  • Great need (or interest) in medical center for non-drug treatment option such as acupuncture that decreases ER return rates, inpatient hospital stay length, and surgery recovery statistics [see Allina example of incorporating EAMPs/L.Ac.s in the ER]  



Hospital Sponsor is Innovator and Synergist, more than your average Administrator
The hospital sponsor is usually a physician who has some administrative time allowed in schedule or is incredibly motivated.  The hospital sponsor will next do one of the following:

  1. Request to hire one L.Ac., in her area of hospital.  For example, the hospital sponsor is main provider at a OB clinic and wants to add an L.Ac. to her staff.
  2. Request to hire multiple L.Ac.s as part of a creation of a specific Integrative Medicine (IM) clinic or healthcare system-wide creation of IM clinics, such as for pain management and/or IM rehabilitation clinics


Among other things, the hospital sponsor will have to do the following:
Get idea approved by hospital admin
Create a position description for the L.Ac.
Create a hiring package with HR for the L.Ac.
Create a credentialing package for L.Ac., working with the credentialing department
As part of hiring process, present credentialing packet and drafted delineation of clinical privileges to the hospital credentialing committee on behalf of the soon-to-be hired L.Ac. employee

When working with Credentialing department specialist to create packet, the following is often helpful:
Useful items when working with the credentialing department and credentialing committee:
The state’s scope of practice for practitioner
Position description created for L.Ac.


Once L.Ac. is hired, and if she is the first L.Ac. ever to be hired by this medical center, the hospital sponsor:

Works with the L.Ac. to develop basic SOP (standard operating procedures) based on her industry standards and experience. 

The L.Ac. is able to direct her hospital sponsor to her national standard organizations to find the best and most current standards and regulations that may apply.  Contact your national EAM/AOM standard organizations and see your EAM/L.Ac. Hospital practice group on social media for examples.

acronyms
IM = integrative medicine
PCMH = patient-centered medical home
L.Ac./EAMP = state license titles for Acupuncturist.  "Licensed Acupuncturist (L.Ac.)" and "East Asian Medicine Practitioner (EAMP)".  Most common state title is L.Ac. 

Read more about how to Get Your Foot in the Door of Hospital-based Practice: First Steps, a new (2019) publication on the website and its companion resource, The Workbook


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