Involving NPs and PAs in peer review
How should nurse practitioners (NP) and physician assistants (PA) participate and be involved in peer review?
Robert J. Marder, MD, author of Effective Peer Review, Fourth Edition, and developer of the Peer Review Evaluation Program: The basic philosophy is that a peer review committee does not have to have an NP and a PA on it because physicians are overseeing them. And physicians have equal to superior privileges of an NP or a PA, so it’s not a requirement for them to be on a committee.
With that said, having diversity of opinion is always a good thing. If you wanted to have an NP or a PA to give that perspective, I would recommend having a senior nurse executive on your peer review committee to give that broader perspective or even someone from the administration. I very much believe that having one on a committee would be useful.
However, I would suggest that they shouldn’t vote on physician care issues. And if they shouldn’t vote on physician care issues, then I would think they wouldn’t vote on NP and PA care issues with the committee as well. But, I do believe it is useful to get that perspective. As an example, sometimes the decision of the committee can be that the care by the physician was not appropriate because the PA did things right but the physician actually didn’t supervise him or her well. So, absolutely they can be involved in a perspective way.
Also, many nursing departments are creating nursing peer review, and I’ve worked with some of those too. Cases for NPs and PAs might go to those types of review committees as well, but any of their findings that affect how physicians should supervise should come to the physician committee for review and approval.