This week's problem is addressed by Jon Moses, MHA. Mr. Moses is President and CEO of MDReview which he co-founded. He is a former hospital CEO with over 25 years senior hospital leadership experience.
Problem:
"When we engage an external peer review company, we get minimal information about the reviewer. As a result, the review findings are often challenged."
Solution:
Five years ago, it was quite normal for external peer review
companies to keep private the name of the external reviewer. Sketchy details were provided requiring
somewhat of a leap of faith that the reviewer was appropriate for the review. This approach spoke to the fear and anxiety
among physicians who were asked to participate in peer review. Protecting the physician's identity was a way
to make such involvement more palatable. But the need to protect the reviewer by
concealing his/her identity seemed to take precedence over the needs of those
commissioning the review.
Without the hospital's ability to know the reviewer's identity, it is easy to
see why the findings could be challenged. After all, who wants expert opinions of any
kind when we can't see for ourselves that the expert is credible? Given what could be at stake, hospitals and
other healthcare organizations requiring external peer review have every reason
to insist, at a minimum, on their own verification of the reviewer's
credentials. Further, it is not unreasonable
to demand involvement in reviewer selection. Leadership will no doubt face challenges to
the peer review process. Without being
able to demonstrate the credibility of the physician chosen to conduct the
review, the entire process can be in jeopardy, as can the trust so integral to
effective peer review.
Always insist on seeing the CV of the physician being proposed to review each
case as well as the ability to reject anyone proposed. When leadership (and sometimes the physician
under review) can determine who is to conduct the review, there is far greater
likelihood that the results will be found credible and less likelihood that the
focus will be on the process rather than the findings. As unlikely as it may be, always plan as if
the results could be presented in a fair hearing other judicial process. You have not only the reason, but the
responsibility to ensure that the reviewer is, in fact, a credible peer.
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