The hazards of 'sham' peer reviews: 6 things to know

Peer reviews occur when a patient, fellow physician or staff member reports a physician for acting improperly or not meeting patient care standards.

A "sham" peer review is used to target a physician for unrelated personal, professional or nonmedical reasons.

In an Oct. 30 report, Medscape Medical News examines the prevalence and impact of sham peer reviews. Key takeaways include:

1. A forthcoming Medscape report finds 56% of surveyed U.S. physicians are "highly concerned" about peer review misuse.

2. "The biggest misconception about sham peer reviews is a denial of how pervasive they are," said Andy Schlafly, general counsel for the Association of American Physicians and Surgeons, which offers a free consultation service for physicians facing sham peer reviews.

3. Data on sham peer review frequency is limited, per Medscape. Lawrence Huntoon, MD, PhD, who has overseen the AAPS sham peer review hotline for over 20 years, says physicians employed by large hospital systems are most vulnerable.

4. Sham reviews may follow complaints filed through incident reporting software. Complaints of "disruptive" conduct, such as a facial expression or tone, are sometimes cited as grounds for action. "This can be used to prosecute a doctor," Dr. Huntoon said, explaining that these reviews often catch physicians off guard with little time to respond.

5. Physicians should avoid resigning if they believe they are targeted by a sham peer review, as this can trigger an "adverse report" to the National Practitioner Data Bank. Moreover, by resigning, physicians waive their right to challenge the review.

6. Early legal representation is advised. "Don't wait a year to get an attorney involved," Dr. Huntoon said. "It's critical to find someone experienced with sham peer reviews and data bank reporting requirements."

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