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Licensing, Credentialing, and Self-Regulation

Licensing,Credentialing, and Self-Regulation

Credentialingis a procedure that is used to scrutinize the qualifications of anorganization, professionals, or members of a particular group as wellas establishing the legitimacy and background that is supposed to bemet by the professionals of a particular field (Chaudhry et al.,2013). Licensing refers to the necessary process that is used by thegovernment to give permission with limits to individuals so that theycan engage in certain occupations after they have credentialed. It isimportant that professionals in the healthcare are credentialedbefore the government licenses the professionals (Chaudhry et al.,2013). The purpose of this report is to discuss the role played bylicensing and credentialing, as well as the influence ofself-regulation in the sustainability of health care organizationsand quality patient care.

TheIntended Role of Licensing in the Healthcare

Thelicensing of professionals intends to improve the quality of servicesthat the patients get from the healthcare professionals (Chaudhry etal., 2013). The services are enhanced by ensuring that physicians whodo not meet the standard criteria do not offer any services becauseit is only through a permit that they can be allowed to operate(Coventry et al., 2014). As a way of trying to control the standardsof the services to be offered, licensure applies two methods. First,every professional must prove that he or she is capable of deliveringquality services by showing that he has met the essentialqualification that is required (Coventry et al., 2014). Theeligibility may vary from one field of medicine to the other. Thereis a basic education and training that is expected from theprofessionals who want to be licensed (Hemphill et al., 2015).Besides, the physicians can demonstrate their capability by showingthat they have passed a certain test or they are members of a certainprofessional body. Nevertheless, the doctors are required to renewtheir licenses may be on a yearly basis. The main aim of doing so isto prove that they have been delivering quality services to thepatients (Hemphill et al., 2015). The second method that is used bythe licensure to make certain that doctors provide patients with thebest services is the revoking of permits (Arora et al., 2014).Licensure has the power to revoke a practitioner`s license if thereis any concrete evidence of malpractice or services that aresubstandard. Due to this reason, doctors are always providingservices of high quality to patients. Licensing also plays a majorrole in controlling the market (DeNisco et al., 2012). If doctorswere not licensed, those professionals with little qualificationswould come into the market and start offering low-quality services ata lower price (Coventry et al., 2014). The final results would beunfair competition, and the individuals who would suffer theconsequences would be the patients (DeNisco et al., 2012). Thepatients would be choosing to consult doctors charge lower priceswithout the knowledge of trusting their health to people who areunqualified (DeNisco et al., 2012). Therefore, the major role oflicensing in the healthcare is to ensure that patients are treatedaccordingly without any exploitation (DeNisco et al., 2012).

TheIntended Role of Credentialing in the Healthcare

Thefirst function of credentialing is to guarantee the public that thehealth is being handled by people who have been seriously scrutinizedand their competencies have been accredited (Chaudhry et al., 2013).In other words, the credentialing is paramount in instilling publicconfidence in the healthcare providers (DeNisco et al., 2012). Inmost cases, patients do not have ways that they can use to recognizethe qualification of the professionals that they are trusting withtheir lives (DeNisco et al., 2012). Every physician must becredentialed before being awarded a license to practice medicine(Chaudhry et al., 2013). Besides, credentialing is important toprivate clinics because it helps in improving the image andreputation of the hospitals in the eyes of the public as well as thedoctors. Also, credentialing enhances the credibility of the clinics.Patients will be confidence when seeking treatment in hospitals whosecare providers are thoroughly scrutinized before gaining employment(DeNisco et al., 2012).

IntendedRole of Self-Regulation Relating to Licensing and Credentialing

Self-regulationis a complement to credentialing and licensing in the healthcare(Chaudhry et al., 2013). The rationale for the professionalregulation is mainly to protect the patients from incompetentphysicians. Since patients do not have the necessary skills that theycan use to diagnose the disease that they are suffering from, theyare forced to seek the attention of the caregivers (Chaudhry et al.,2013). As a result, they have to trust the caregivers. In most cases,patient`s confidence and trust in a physician are usually boosted bythe qualification of a medical doctor (Coventry et al., 2014).Therefore, it is vital that the healthcare professionals ensure thatthey regulate their behavior by refraining from making claims ofcures that are not real, giving wrong qualifications about themselvesor engaging in any malpractices (Coventry et al., 2014). If theprofessionals participate in such behaviors, they will betray thetrust of their patients.

TheInfluence of Self-regulation and Professional Licensing andCredentialing on the Sustainability of Health Care Organizations andthe Quality of Patient Care

Self-regulation,professional licensing, and credentialing play a vital role inensuring that patients receive high-quality services by making surethat only qualified professionals are licensed to treat patients(Chaudhry et al., 2013). Also, self-regulation helps in upholdingethics among the caregivers (Coventry et al., 2014). Due toprofessional licensing, healthcare organizations are made up ofqualified professionals who can regulate their behaviors thus makingthe organizations sustainable (Chaudhry et al., 2013).


Tosum up, it is important that the healthcare organizations scrutinizethe caregivers so that they can protect the general public fromincompetent care providers who can put the health of patients atrisk. Besides, physicians should self-regulate their behaviors sothat the public can have confidence in them.


Arora,K. S., Douglas, S., &amp Dorr Goold, S. (2014). What BringsPhysicians to Disciplinary Review? A Further Subcategorization. AJOBEmpirical Bioethics,5(4),53-60.

Chaudhry,H. J., Cain, F. E., Staz, M. L., Talmage, L. A., Rhyne, J. A., &ampThomas, J. V. (2013). The evidence and rationale for maintenance oflicensure. JMed Regul,99,19-26.

Coventry,B. J., Hughes, C., &amp Webb, R. (2014). Accreditation,Credentialing, Scope of Practice, and Outcome Evaluation. In GeneralSurgery Risk Reduction(pp. 317-336). Springer, London.

DeNisco,S. M., &amp Barker, A. M. (2012). AdvancedPractice Nursing.London: Jones &amp Bartlett Publishers.

Hemphill,T. A., &amp Knesek, G. (2015). The Non-Physician Remedy to thePhysician Shortage. Regulation,38(2),2.