Hospitals and medical staffs all too often experience predictable areas of strife for which external peer review can prove to be a useful conflict resolution tool. We’ll bet you have at least three of these going on right now. You are not alone.
- Trust Issues When competing physician groups in the same specialty must conduct peer review on each other, allegations of bias can obstruct collegial, effective oversight and accountability.
- Shiny New Toys When an individual or small group of physicians is driving a new technology or procedure with questionable indications, efficacy, and risk.
…your medical staff’s peer review cannot solve these problems, might actually be part of the problem, or may actually lead to an escalation of the conflict.
- Rose Colored Glasses When the management of a hospital or system has concerns about the quality or medical necessity of care–red flags in their view of a particular service line or specialty—while the medical staff thinks “all is well.”
- Witch Hunt vs. Just Cause for Concern When a hospital or medical staff is considering corrective action against a physician and the physician pushes back – perhaps even threatens to sue.
- Narrow Specialty When an individual or small group of physicians with a very particular specialty claim no one else on the medical staff has the experience or knowledge to review their cases as peers.
- Privileging Turf Battles When two groups of specialists disagree wholeheartedly and persistently over diagnoses, procedures, and quality of care (think neurosurgeons vs. orthopedic spine surgeons for back pain surgery and cardiologists, vascular surgeons, and interventional radiologists doing battle over peripheral vascular procedures.)
- Clinical Autonomy vs. Risk Tolerance When one or more physicians are “aggressively” performing procedures or writing orders that constitute undue (compliance and/or legal) risk in the eyes of management or their peers.
All too often your medical staff’s peer review cannot solve these problems, might actually be part of the problem, or may actually lead to an escalation of the conflict.
So what’s the one tool that can help solve every one of these conflicts? External peer review. Used and managed properly, external peer review provides a trusted partner outside the organization to evaluate the quality and medical necessity of physicians’ care through impartial, respected, clinically compelling evaluations. To discuss further how external peer review can help solve the toughest conflicts, submit your challenge below and we’ll be in touch soon.
- Who are you sending to Peer Review Boot Camp?
- Can Mars and Venus Really Get Along? Part I: When Physicians Join a Hospital/System
- Can Mars and Venus Really Get Along? Part II: When a Hospital/System Joins with Physicians
- 6 Questions Your External Peer Review Policy Should Address
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