Peer review

Peer review is essential for ensuring quality medical care. In the 1980s a physician-plaintiff prevailed in lawsuit filed against peer reviewers who e xcluded the physician from a hospital's medical staff. The peer reviewers h ad acted to preserve their own economic interests. A multimillion-dollar ve rdict against the peer reviewers destroyed the community's only multispecia lty practice and received national attention. Congress reacted by passing t he Health Care Quality Improvement Act that granted sweeping, legal immunit y for peer reviewers but also created the National Practitioner's Data Bank . The combination of the establishment of a public repository for physician s malpractice and medical staff privileging activity in combination with th e near complete legal protection of peer reviewers has converted peer revie w from an evaluative to a punitive process. The peer review process and the laws that govern it should be reformed to regain its ability to improve an d assure quality without being a, threat to physicians. (C) 2001 Excerpta M edica, Inc. All rights reserved.