Medicine Redefined 184. Fixing Credentialing and the Future of Physician Autonomy | Leah Houston, MD
Sep 29, 2025
Dr. Leah Houston, an emergency medicine physician and healthcare entrepreneur, shares her mission to fix the broken credentialing system. She discusses the widespread issues in physician credentialing and how AI and decentralized identity can restore autonomy to doctors. Dr. Houston highlights the burdensome timelines and manual processes that hinder mobility. She advocates for digital solutions like credential wallets and real-time license verification to streamline workflows. Her vision includes a future where direct payment models reduce insurance dependency, enhancing care for patients and restoring trust in healthcare.
AI Snips
Chapters
Transcript
Episode notes
Credential Fraud That Halted Her Work
- Dr. Leah Houston discovered hospitals were billing under her name after her license lapsed, revealing credential fraud.
- The fraud prevented her from working for five months and triggered a legal battle to prove she wasn't practicing there.
Credentialing Is Three Locked Gates
- Credentialing comprises licensing, privileging, and payer enrollment and tightly controls physician mobility.
- Without verified credentials you cannot get paid, work, or easily move between systems.
Outdated Rules Still Drive Credentialing
- The modern credentialing regime grew from a vague 1996 CMS letter and Joint Commission enforcement.
- Legacy paper-era rules persist despite digital tools that could simplify verification.