What is a Physician Peer Review?

Marlene Garcia

A physician peer review is a system where doctors evaluate the performance and quality of patient care of their peers in the profession. The process is required in hospitals, outpatient health clinics, nursing homes, and medical groups, especially after a patient dies or is injured after receiving medical care. Physician peer review panels determine whether the doctor’s clinical care of his or her patient meets the acceptable standard for patient safety.

Some hospitals use outside peer reviewers.
Some hospitals use outside peer reviewers.

These review committees consist of doctors with the same training and experience as the physician under scrutiny. They commonly report their findings to medical boards that are responsible for issuing physician licenses and revoking them. The physician peer review panel determines if the doctor in question was competent, negligent, impaired by alcohol or drugs, or incompetent to practice medicine. Doctors who perform the review can also recommend corrective measures, such as additional education, to ensure the mistake does not happen again.

Physician peer review takes time, but improves the quality of care offered to patients.
Physician peer review takes time, but improves the quality of care offered to patients.

Many physician peer review procedures are handled internally by hospitals that employ doctors on staff. The panel is given access to all medical records concerning an incident that is being questioned. Some review panels allow the physician under review to attend the meeting to explain his or her decision for the type of medical care administered. The deliberations and results of the process are commonly confidential, and the doctors sitting on the panel are immune from lawsuits.

Some hospitals use outside sources in an effort to get independent and unbiased finders of fact. This type of physician peer review helps eliminate the possibility of doctors protecting their colleagues, or becoming critical of competitors in a certain field of medicine. These reviews might use only the patient’s medical records to conduct the evaluation, eliminating any chance of personalities entering into the decision.

Examples of the types of cases that may prompt a physician peer review are the administration of the wrong drugs, surgery that was unnecessary or conducted on the wrong part of the body, or the improper use of restraints. Doctors can also come under peer review for unprofessional conduct or suspicion of substance abuse. The goal of the process is to protect the public from incompetent doctors, and to rehabilitate physicians who make an unintentional mistake.

Hospitals can use a physician peer review report to weigh the potential liability when a lawsuit has been filed. If hospital risk managers see strong evidence that doctor error caused death or injury to a patient, they may settle the case outside court. Doctors who are the subject of complaints are sometimes listed in a database that hospitals can access before hiring physicians.

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