When physicians are given feedback data regarding outcomes, a common response is “My outcomes are worse because my patients are sicker.” This concern is legitimate and should be addressed by...
Leading up to the 21st century, peer review evolved constantly, undergoing rapid change. New regulations and requirements were implemented both by the Centers for Medicare & Medicaid Services (CMS) in the 1960s and by the establishment of the Health Care Quality Improvement Act of 1986....
Unfortunately, ineffective peer review can and does happen at hospitals across the country. An organization's ineffective peer review system may be brought to light by examining publicly reported performance measurements, successful lawsuits that are the results of poor physician performance, or...
Typically, recommendations for external peer review (EPR) arise from peer review committees that are faced with issues they can't resolve—lack of specialty expertise, conflicts of interest and other potential legal or credibility issues. The board should also have the right to determine whether...
The degree to which credentials files can be protected from discovery in legal proceedings is generally a matter of state law. Most credentialing work is considered a peer review activity performed by the medical staff and governing board. As a result, state laws generally grant some amount of...