We recently delivered a background investigation on a prospective employee that included the following offense history:
- Theft less than $500 (2014)
- Theft valued at more than $500 (2012)
- Forgery (2012)
This client is a medical office.
Might this offense history be relevant to the medical office as they evaluate the applicant for employment?
The Risks Associated with the Position
In evaluating this applicant’s fitness for the role sought, it would be important for the medical practice to first examine the specific risks associated with the position.
Some employees may have close-physical contact with patients.
Others may never speak to a patient but will have access to their personally-identifiable information (e.g., social security numbers, dates of birth, address, etc.), insurance and financial information, and medical information.
Patients’ belongings may be left unattended at times.
Or, depending on the procedures being sought, patients may be under anesthesia or otherwise not fully aware of their environment.
Additionally, some employees may have access to medications or prescription pads.
Different roles will have different risks. The risks associated with a receptionist in the medical office may be different than that of a nurse in the same office.
There are undoubtedly other risks but for this review, one might speculate that the risks for each role are as follows:
| Risks | Receptionist | Nurse |
| Physical contact with patients | No | Yes |
| Access to patient PII | Yes | Yes |
| Access to insurance or financial information | Yes | Yes |
| Access to patient medical information | Yes | Yes |
| Access to patient belongings | No | Yes |
| Access to medications | No | Yes |
| Access to prescription pads | Yes | Yes |
It is important to note that some of these risks are not directly related to items in the job description but simply arise from having access to the workplace.
For example, a receptionist might not need access to prescription pads in order to perform his job. However, it is possible that at some point they might simply because they have access to the work area.
Because every business puts different controls in place, the risks identified in similar roles will vary in different medical practices. For instance, one medical office may have very strict procedures for securing prescription pads while another may be more lax about this.
The Relationship of the Identified Risks to the Offenses
When considering whether a past offense is related to a job responsibility, we generally rank the correlation as high, medium, or low.
A medical office may consider the risks noted above with the following correlations to the criminal history returned in the background investigation:
| Risks | Theft | Forgery |
| Physical contact with patients | Low | Low |
| Access to patient PII | High | High |
| Access to insurance or financial information | High | High |
| Access to patient medical information | High | High |
| Access to patient belongings | High | High |
| Access to medications | High | High |
| Access to prescription pads | High | High |
Because theft and forgery are both reflective of dishonesty, both offenses are generally rated high with regard to the sample job responsibilities.
An example of an offense that may not be strongly correlated with the risks associated with a job in a medical practice might be driving while intoxicated (DWI).
| Risks | DWI |
| Physical contact with patients | Medium |
| Access to patient PII | Low |
| Access to insurance or financial information | Low |
| Access to patient medical information | Low |
| Access to patient belongings | Low |
| Access to medications | Medium |
| Access to prescription pads | Medium |
In the context of the actual applicant’s criminal history, it seems likely that both offenses would be highly correlated to the identified position risks.
Time Passed Since the Offenses
These offenses occurred more than six years ago.
Might that passing of time mitigate some of the risk presented by this applicant?
Some employers have policies that limit their consideration of criminal history to items that occurred in the past seven years. Indeed, a few states have restricted employers’ ability to consider criminal history older than seven years.
There is very little science to suggest that an individual is less likely to commit a new offense after a specific time period.
But generally, the more time that has passed without new offenses (assuming the individual didn’t spend a good bit of that time incarcerated), the more comfortable most employers are in considering applicants with even high-risk offenses.
While the offenses on this background check may not be very recent, they are highly correlated to the risk associated with roles the medical provider’s office.
Consider again the hypothetical DWI above.
A medical practice may be very comfortable hiring a receptionist with a DWI that is two years old but may be more concerned about the same DWI with a nurse, where a heightened level of compliance, safety awareness, and personal responsibility may be required.
Consider the Whole Applicant
I often remind employers that criminal history-related risk is but one evaluation of an applicant’s fitness for a role.
Experience, skills, and education should also be included in the evaluation.
In this example, the medical practice might consider how the applicant has conducted herself since these offenses.
Has she been consistently and successfully employed in roles with similar responsibilities?
Did she obtain additional education or professional certifications related to the role?
It makes some employers uncomfortable, but I encourage frank conversations with candidates about their criminal history.
Consider open ended questions like:
- Will you tell me about your criminal history, please?
- What were the circumstances surrounding these offenses?
- How can you demonstrate that the person that made the choices leading to those criminal cases is not the person sitting in front of me today?
- What did you learn from those experiences?
The employer should then ask themselves:
- Does the applicant justify or shift blame for their actions?
- Do they accept responsibility for their past actions? If not, do their explanations seem credible?
- Can they demonstrate that their past critical errors in judgment or bad behavior are not indicative of the judgment or behavior they will demonstrate as an employee?
- On the whole, does hiring this person present a greater risk or opportunity to the company?
What Do You Think?
Would you consider this applicant for a position in a medical office, either as a receptionist or a nurse?
What other factors would you consider in evaluating her?
Based on their age, are these offenses even relevant to the job?
Let us know in the comments below!
