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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Clinical peer review | 5/5 | https://en.wikipedia.org/wiki/Clinical_peer_review | reference | science, encyclopedia | 2026-05-05T09:52:52.389008+00:00 | kb-cron |
Sham peer review is a name given to the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons. State medical boards have withheld medical records from court to frame innocent physicians as negligent. Another type of review similar to sham peer review is "incompetent peer review," in which the reviewers are unable to accurately assess the quality of care provided by their colleagues. Controversy exists over whether medical peer review has been used as a competitive weapon in turf wars among physicians, hospitals, HMOs, and other entities and whether it is used in retaliation for whistleblowing. Many medical staff laws specify guidelines for the timeliness of peer review, in compliance with JCAHO standards, but state medical boards are not bound by such timely peer review and occasionally litigate cases for more than five years. Abuse is also referred to as "malicious peer review" by those who consider it endemic, and they allege that the creation of the National Practitioner Data Bank under the 1986 Healthcare Quality Improvement Act (HCQIA) facilitates such abuse, creating a 'third-rail' or a 'first-strike' mentality by granting significant immunity from liability to doctors and others who participate in peer reviews. The American Medical Association conducted an investigation of medical peer review in 2007 and concluded that while it is easy to allege misconduct, proven cases of malicious peer review are rare. Parenthetically, it is difficult to prove wrongdoing on behalf of a review committee that can use their clinical and administrative privileges to conceal exculpatory evidence. The California legislature framed its statutes so as to allow that a peer review can be found in court to have been improper due to bad faith or malice, in which case the peer reviewers' immunities from civil liability "fall by the wayside". Dishonesty by healthcare institutions is well-described in the literature and there is no incentive for those that lie to the public about patient care to be honest with a peer review committee. Incidents of alleged sham peer review are numerous and include cases such as Khajavi v. Feather River Anesthesiology Medical Group, Mileikowsky v. Tenet, and Roland Chalifoux. Defenders of the Health Care Quality Improvement Act state that the National Practitioner Data Bank protects patients by helping preventing errant physicians who have lost their privileges in one state from traveling to practice in another state. Physicians who allege they have been affected by sham peer review are also less able to find work when they move to another state, as Roland Chalifoux did. Moreover, neither opponents or supporters of the NPDB can be completely satisfied, as Chalifoux' case shows that just as physicians who were unjustly accused may be deprived of work in this way, those who have erred might still find work in other states.
== See also == Subpoena duces tecum Utilization management
== References ==
== Further reading == NPDB Guidebook: The NPDB Guidebook (last accessed 2/11/19) Steve Twedt (2003-10-26). "The Cost of Courage: How the tables turn on doctors". Post-Gazette. PG Publishing. Magazine Staff (2006-08-01). "All Is NOT Calm on the Hospital-Medical Staff Front". Southern California Physician. LACMA Services Inc. Archived from the original on 2006-09-02. Charles Bond (2005-11-15). "Editorial in Response to "What Is Sham Peer Review?"". Medscape General Medicine. 7 (4): 48. Goldstein H. (2006). "Appraising the performance of performance appraisals". IEEE Spectrum. 38 (11): 61–63. doi:10.1109/6.963247. Philip L. Merkel (Winter 2004). "Physicians Policing Physicians: the Development of Medical Staff Peer Review Law at California Hospitals" (PDF). University of San Francisco Law Review. 38 U.S.F. L. Rev. 301. Bryan G. Hall (Fall 2003). "The Health Care Quality Improvement Act of 1986 and Physician Peer Reviews: Success or Failure?" (PDF). University of South Dakota Elder Law Forum.