Medical peer review
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Medical peer review is the process by which a committee of physicians investigates the medical care rendered in order to determine whether accepted standards of care have been met. A Medical Peer Review typically will provide independent medical opinions conducted by an objective group of physicians and relevant medical staff that quickly resolve complex problems that hospitals, physicians and insurance carriers face. Usually, the review of chart notes and operative reports are enough to render objective written opinions that can help reach the right decision while reducing legal risk.
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[edit] Impartiality
The importance of impartiality (i.e. independent adjudication acceptable to all parties) has been stressed by conflicts of interest (professional competition through defamation: See Semmelweis Society International). A medical peer review committee can act at the request of a patient, a physician, or an insurance carrier depending on the politics of the venue.
[edit] Independent committee
Ideally but not necessarily generally, an independent committee of peers acceptable to the physician impartially reviews the randomly, impartially-selected work to offer with the benefit of hindsight an unbiased (third-party independent medical reviews) evaluation of the quality of care.
The medical peer review committee investigates the medical care rendered in order to determine whether accepted standards of care have been met. The professional or personal conduct of a physician may also be investigated. If the medical peer review committee finds that the physician departed from accepted standards, it may recommend limiting or terminating the physician's privileges at that institution; remedial measures including education may also be recommended.
[edit] Abuse
Controversy exists in the USA because peer review has been used as a competitive weapon to gain "market share" in turf wars among physicians, hospitals, HMO's, and other entities. The creation of the National Practitioner Data Bank facilitates such abuse, essentially creating a 'third-rail' or a 'first-strike' mentality instead of a sober attempt to protect patients through professional medical integrity.
There is a shortage of physicians in the USA. The absence of due process in medical peer review may affect medical manpower in that country.
- See also: Specialty medical peer review, Utilization review, and Utilization management
[edit] References
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