Disciplined Physician Peer Review – Never Go Off Script
Peer review is far more complex than most people, even those within healthcare, realize. From the laws that apply to the careers and reputations at stake, the strategies that must be considered, the costly mistakes that can be made, peer review expertise is a highly valuable asset. The greatest expertise often rests with attorneys who specialize in medical staff matters. Consulting such experts is a worthy consideration, especially when there is the potential for conflict to arise in the context of peer review. Even with the many years of experience I have in managing some of the most complex peer review projects, both as a hospital executive and as a peer review consultant, I give serious consideration to consulting other experts. Why? Because mistakes come at such a high price. As leaders, we owe it to everyone affected, including patients, to get it right. The results as well as the process will often come under intense scrutiny; they must be defensible.
One of the most common pitfalls in peer review is to go off script; to act in a manner that is inconsistent with the medical staff bylaws or policies and procedures. If this happens, defensibility breaks down. When faced with challenge to the process, I never want to be in a position of having to defend which path was more appropriate, the one approved by leadership or the one I chose. When I go off script, I am sitting duck, bringing a big smile to the face of any adversarial attorney.
Here is the very simple, very basic advice: Do not go off script. If the bylaws or policies need improvement, work to get them changed. Regularly scrutinize any approved, guiding documents to make sure you can adhere to what is written and approved. When in doubt, consult an outside expert. Your diligence will pay big dividends by protecting everyone involved from perilous practice.