Peer Review
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 their medical judgment
freely with their 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:
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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.
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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.
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"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.
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"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.
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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.
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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