Why a medical license isn’t enough for quality healthcare

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It’s official: you need surgery and have no idea where to start looking for a surgeon who is not only approved by your medical insurance, but also located within a reasonable distance from your home.

If that isn’t already overwhelming enough, just because a medical professional has a license to practice medicine doesn’t mean she is board certified in her specialty, or has permission to provide treatment at a hospital local to you. Adding to this uncertainty, it’s also hard to know if a surgeon has a successful track record in the cases they’ve performed.

In the United States, a medical license is the minimum requirement to diagnose and treat patients. All physicians and medical specialists in the U.S. must be licensed to practice medicine by their state’s licensing board.

While each state’s specific licensing requirements may vary, in general, doctors are required to successfully pass certain exams and demonstrate compliance with the medical licensing authority’s rules, regulations and conduct/ethical standards. Again, this is the standard minimum to practice medicine.

But a medical license does not mean the doctor is board certified in a particular medical specialty, such as orthopedic surgery.

Much like your best-of-the-best professionals in any field, the top surgeons in every specialty have robust career track records that exceed the bare minimum, including board certifications, residency and fellowship training, research and publications, professional references, and more. As an individual, you don’t have the time nor the access to the resources for investigating and verifying the credentials of every one of your potential doctors.

The great news is, you don’t have to: all members of SurgeryPlus automatically have access to our nationwide network of highly qualified and carefully selected medical professionals designed to ensure high-quality care. We do this by only accepting doctors who meet our exceptional credentialing standards, which include the following:

  • Board Certification in his/her specialty/specialties
  • Specialty Training Requirement
  • Continuing Medical Education
  • Surgeon-to-Surgeon Reviews
  • State Sanctions Check
  • Medical Malpractice Claims Review
  • Background Review
  • Quality Scores
  • Monthly Network Monitoring

Your health is our gold standard

“A physician only becomes a SurgeryPlus provider by meeting our rigorous quality standards, which are not like the typical carriers’ standards,” explains SurgeryPlus Director of Member Services Rachel Vanlandingham. “We spend time educating our members on how we add providers, including providing education on what board certification, licensing, fellowship trained or state sanctions mean for them and their care.

“A physician only becomes a SurgeryPlus provider by meeting our rigorous quality standards, which are not like the typical carriers’ standards,”


“We make sure they know what is important for them to know for the best surgical care,” Vanlandingham states. “Highly qualified and carefully selected surgeons are chosen not only for their expertise, but also their bedside manner. It’s this combination that results in our complication and readmission rates being under 1% — well below the national average.”

SurgeryPlus delivers the care and support you deserve, at the value you want

In addition to thousands of surgeons who are the best in their fields, our high-performance network is continually growing to find the best care for you, as close as possible to home. With hundreds of facilities to choose from, the SurgeryPlus network is designed to be easily accessed. If the best surgical care is not close by, it can be reached within a reasonable car ride — often times just under 65 miles. If lengthier travel is necessary, SurgeryPlus covers any travel expenses to make sure you get the care you need.

“Our network is built with the member’s care as our top priority,” says Vanlandingham. “Our personal Care Advocates hand-select three surgeons for a member’s consideration. The member then selects the surgeon that’s right them. The choice is up to the member — we just make it more accessible.”

To learn more about your SurgeryPlus benefits, contact us via one of the methods below to discuss your planned surgery needs with a Care Advocate. Our Care Advocates work with you throughout the entire process and manage the details of your treatment plan, including identifying top-rated surgeons, scheduling appointments, transferring medical records, and arranging travel. The choice of a top-rated surgeon is in your hands — EDH just simply makes it easier to access!

Contact a SurgeryPlus Care Advocate today to learn more.

Call: 855.200.2099 | Email: Advocate@EDHC.com

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