Summary: In response to a congressional request, GAO reviewed the procedures and processes the Department of Defense (DOD) uses to ensure that its physicians are medically qualified, to determine the: (1) adequacy of the DOD approach; and (2) impact of new licensing requirements on DOD unlicensed physicians and the military health care system.
GAO found that: (1) although the military services have substantially tightened preemployment screening since 1984, they have not fully implemented DOD requirements which would ensure that only qualified physicians practice medicine in military hospitals; (2) 53 percent of the 426 physicians' records it reviewed did not contain authenticated medical diplomas, and most lacked complete or adequate documentation to support the award of clinical privileges; (3) many physicians did not meet the DOD requirement for a current state license, while about 1,200 had never been licensed; (4) DOD expressed concern about the possible effects on patient access to health care if a large number of unlicensed physicians were prevented from practicing medicine independently; (5) DOD waived licensing requirements for several foreign national physicians practicing in overseas DOD facilities and plans to continue doing so on a case-by-case basis; and (6) to improve its credentialing system's efficiency, the Army established a central database on individual physicians, including authenticated information on education, training, experience, certification, and licensing.