Ask the expert: When should the medical staff consider external peer review?

The peer review committee recommends external peer review to the medical executive committee (MEC)—not the physician under review. Typically, external review is recommended when:

• A medical staff member or the hospital is under the threat of a potential lawsuit
• The medical staff is dealing with vague or conflicting recommendations from internal reviewers or medical staff committees and when conclusions from this review will directly affect a physician’s membership or privileges
• No one on the medical staff has adequate expertise in the specialty under review or the only physician(s) with that expertise have conflicts of interest with the physician under review
• A medical staff member requests permission to use new technology or to perform a procedure new to the hospital and other medical staff members do not have the necessary subject matter expertise to evaluate the quality of the care involved

This week’s question and answer were adapted from Effective Peer Review: A Practical Guide to Contemporary Design by Robert J. Marder, MD, CMSL; Mark A. Smith, MD, MBA, FACS, CMSL; and Richard A. Sheff, MD, CMSL.