Peer Review, WSMA Principles of

The WSMA supports peer review in the forms of medical society ethics committees, hospital credentials and utilization committees, and other forms of peer review that have been long established by organized medicine to scrutinize physicians' conduct. The WSMA supports peer review as a balance between the physician's right to exercise his/her medical judgment freely with his/her obligation to do so wisely and temperately. (JC 9.09-87; B-3, A-15)

The WSMA strongly believes that peer review is best accomplished by a physician-sponsored and managed organization with review being performed by local practicing physicians in the same specialty as the physicians being reviewed. (PA Rpt B, '91; PA Rpt B, '90; B-3, A-15)

The WSMA will work to protect the right of physicians to a fair and professional peer review process as a necessary condition for hospital immunity from physician suit in accordance with the following principles:

1. Medical Staff and Hospital Bylaws must be followed. RCW 70.41.200 and 2007 c 273 s 22 and 2007 c 261 s 3 have been amended to include this provision, but RCW 7.71 should also be amended.
2. The legislative intention of HCQIA and WA RCW 7.71 is to "foreclose federal antitrust actions" which were the basis of 1988 US Sup Ct decision, Patrick v. Burgets, but the intention was not to endorse "economic credentialing" in the absence of substandard physician performance. Financial bias is a prohibited motive in physician peer review.
3. "Fairness" is unbiased case selection in the peer review process. Cases that fall out of standard medical practice shall be handled in a uniform and standard way between all members of the department.
4. "Professionalism" requires that peer review body decisions conform with standard medical practice and outside expert review. WSMA will continue to develop resources for unbiased expert review.
5. Peer review procedures must allow the protections afforded in other statutes that recognize and protect health care providers and facilities from participating in, or refraining from participating in, actions or practices to which they object on the basis of conscience or religion.
6. When "disruptive physician behavior" is cited in peer review sanction, quality of care complaints that are not disruptive must be excluded. This is defined in the amendment written by the Senate Law & Justice Committee.

(Res B-1, A-13; Res B-1, A-15; B-3, A-15)

The WSMA supports fair process protections for employee physicians, in accordance with Resolution B-1 Fair and Professional Medical Staff Peer Review. (B-1, A-15)

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Abbreviations for House of Delegates report origination:

EC – Executive Committee; BT – Board of Trustees; CPA – Council on Professional Affairs; JC – Judicial Council; CHS – Community and Health Services