Peer Review Proceedings
Peer review, when fairly conducted, is calculated to ensure the highest standards of medical practice. As the California legislature has recognized in the law establishing peer review in California, when it is not conducted fairly it results in harm to patients and to healing arts practitioners by limiting access to care. The California Supreme Court has recognized that an adverse outcome in peer review proceedings can have the effect of ending a physician’s career.
Physicians are entitled to certain minimum requisites of fair process in peer review proceedings as established by statute. Medical staff bylaws may provide for greater fairness in the process, but cannot contravene the legislative protections. The process is usually set forth in detail in the medical staff bylaws.
All too often, peer review investigations follow a breakdown in effective communication or professional relationships, whether with colleagues or hospital employees. This can lead to unwarranted accusations of inappropriate or unprofessional conduct or departures from the standard of care even where there are no adverse patient outcomes. Once the medical staff leaders see a pattern of such reports about a physician, it can become difficult to fairly and objectively evaluate the reports.
While every case is different, a physician should generally engage counsel at the earliest possible time if they are the subject of a peer review investigation. Physicians are not permitted by most medical staff bylaws to be accompanied by counsel in any meetings with the medical staff during a peer review investigation. However, counsel can be of tremendous assistance to a physician during a peer review investigation. Counsel can communicate with the medical staff’s counsel, assist the physician in developing evidence for presentation to the medical staff, and can assist a physician in preparing to meet with the medical staff during the investigation to ensure an effective response. In some cases, counsel can recommend remedial measures that a physician can take to address legitimate medical staff concerns.
Adverse actions, including summary suspensions, will result in reports to the California Medical Board and the National Practitioner Data Bank and can lead to a separate Medical Board investigation.
Rothschild Wishek + Sands LLP has the experience to assist a physician in effectively responding to a medical staff investigation or in review of an adverse action.