Editorials/ Articles and Notices on Peer Review

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Selecting Your Employer
Finding the "Least-Threatening" Institution

If you believe that your "problems" associated with your now private practice will "end" when you become employed, think again. Your selection of your employer is the most important decision you can make and requires enormous investigative efforts. The resources of your employer dwarf yours. Yet, you need to learn about them in detail. .. follow link for details

The Health Care Quality Improvement Act ( HCQIA) Federalized Clinical Peer Review Actions

The Health Care Quality Improvement Act of 1986 ( HCQIA) federalized "clinical review actions" (Peer Review) by a "reporting entity" (corporation, enterprise) in 1986. Before that, there was simply no federal law describing a 'reporting entity", which is in every instance a corporation with its own agenda for using and manipulating medical care doing a "clinical review action subject to "section 11112(2).

So the use of corporate peer review is simply as logically accurate as saying "reporting entity peer review" or more accurately "corporate clinical review action" a precise description of a new species of governance superior to the natural rights of person called physicians with statutory "standards" which was birthed in 1986. ... follow link for full article

Sham Peer Review: No Evidentiary Standards.

No Procedural Due Process...  No Evidentiary Standards... Looks like Physicians and Surgeons, under the Health Care Quality Improvement Act of 1986 ( HCQIA ) remain the only group without their Civil Rights.

Shocking, isn't it?.. follow link for full article


by Richard Willner, CEO
The Center for Peer Review Justice

Regarding "Suspended Physician's Hearing Put on Hold" (AMNews): The concept of a patent's alleged "imminent danger" coupled with legal immunities guaranteed by the federal Health Care Quality Improvement Act of 1986 ( "HCQIA") and similar state laws, followed by the Courts' reluctance it second guess physicians' "professional" opinions, can lead to terrifying results for the physician under fire. Both medical institutions ( e.g. hospitals) and state medical boards can play the "summary suspension" trump card on a hapless victim without fear of significant legal liability or effective judicial review. The physician being so attacked has little recourse, and he or she may suffer terrible and irreparable monetary loss, even if demonstrably "not guilty". (read more)

(follow up on this particular case - Gil N. Mileikowsky, MD)

This is America!! Why no Justice for Physicians and Surgeons?

Physician Brownouts and Hospital Liability
Shifting Up Due to Obama Care

By Richard Willner

I am not shocked to see such a sharp uptick in “Physician Brownout’ sham peer review cases.
Physician Brownout is a term he coined to describe a special kind of peer review or professional retaliation which involves liability shifting for nursing error or any of a number of events where a hospitals has liability for its agents.
“After 11 years and hundreds of cases, you get to be a bit of an epidemiologist on sham peer review. (read more)

Insanity, Senator Style. See my letter in response.

posted  by Richard Willner on Thursday, March 15, 2012 at 3:42pm

Three U.S. Senators have asked federal health officials to review the way state medical boards regulate the nation's physicians.

The request was prompted by recent reports from a citizen's watchdog group and three newspapers, including the Star Tribune, that "highlighted disturbing failures of state medical boards to discipline physicians," the senators said. The letter was signed by Sens. Charles Grassley, R-Iowa; Orrin Hatch, R-Utah, and Max Baucus, D-Montana.

In a Feb. 15 letter, the senators asked the inspector general of the U.S. Department of Health and Human Services to "evaluate the effectiveness" of state boards and provide recommendations on ways to protect the public from "unqualified or marginally proficient practitioners."

Among their concerns, the senators noted that the number of serious disciplinary actions imposed on doctors by state medical boards was 20 percent lower in 2010 than in 2004.

In a Star Tribune investigation of the Minnesota Board of Medical Practice, it was revealed that at least 46 Minnesota doctors escaped board discipline after authorities in other states took action against their licenses for such missteps as committing crimes, patient care errors or having sexual or inappropriate relationships with patients.

The Star Tribune's report, published earlier this month, also showed that the board never disciplined more than half of the 74 doctors who lost their privileges to work in Minnesota hospitals and clinics over the past decade.

The board, which oversees 20,000 physicians, said its record reflects a philosophy of correcting problems rather than punishing practitioners.

A Minnesota legislative commission has recommended that the medical board continue in its current form. However, Rep. Mary Kiffmeyer, R-Big Lake, the commission chairwoman, said the commission plans to meet with board officials at a 9 a.m. public hearing Friday at the State Office Building to talk about questions raised by the Star Tribune investigation.

"In light of the new information, we want to take another look," Kiffmeyer said. "We want to give them an opportunity to defend themselves and [give the commission] an opportunity to reconsider what they want to do. ... This is really about protecting the public and not protecting the doctors."

Modern Peer Review Is Often A Sham!

By Richard Willner

There was a time not so long ago when Doctors could have disputes with hospitals and simply move on. Nowadays, the hospital uses a fraudulent peer review to destroy the doctor’s career.    Follow Link for full story.

The National Practitioner Data Bank ( NPDB)

By Richard B Willner
The Center for Peer Review Justice

The National Practitioner Data Bank ( NPDB) is a 20 year experiment created by an act of Congress along with the Health Care Quality Improvement Act of 1986 ( HCQIA). The experiment has failed. It is time to abolish this agency.

The NPDB is a black list reminiscent of the McCarthy blacklist of the 50s. Instead of targeting the Red Menace, or Communists, the target of this blacklist of the White Menace: "Bad Doctors".

  Follow Link for full story.

Health Care Fraud and Accrual Based Accounting

by Richard Willner, CEO
The Center for Peer Review Justice
May 18, 2011

Let’s be truthful. “Sham Peer Review” is really ”Physician Peer Review Fraud”. Health care fraud is a double entry system of accounting. We must discipline our thinking to reflect that of the accountant and lawyer so engaged in order to find the crooks and gather evidence of their misdeeds. It is pointless to completely focus on the all too necessary whining and sniveling and cross examination of our self worth that the system forces us to do. We eventually only bail water into our own boats and vomit on our friends.
Every time you hear about sham peer review of independent doctors, ask yourself what is on the credit side of each equation. Richard Willner is the chief epidemiologist of this. Is it in the thousands? (read more)

What the Future Holds in Health Care

by Richard Willner

The question before the legislature is should young people be required to sacrifice their civil liberties just to become a physician.

Or should these young people choose another course with …less irrational legal constraint like finance for example.

Should they be required to sacrifice family life and hundreds of thousands of dollars just to work for the momentary pleasure of some corporate hospital huckster. (read more)

Sham Peer Review and Increased Physician Suicide Risk

by Richard Willner

Various stressors have been correlated to physician suicide, including: personal, financial, and profession. Anyone who has been under pressure from a legitimate review process will readily tell you that it can be stressful. If the review is a sham, the stressful nature of the review increases dramatically. (read more)

Availability of Information to Patients as an Offset to Sham Peer Review

by Richard Willner

The present scheme for providing information to patients that would presumably allow patients to minimize their own risks involving the treatment by various doctors is not perfect, to say the very least. Currently, state licensure boards and other disciplinary bodies regulate the flow of physician quality parameters. (read more)

The Center for Peer Review Justice Supports the Coalition to Preserve Patient Choice

Revision of the Any Willing Provider law continues to be the most important statewide legislative issue we face. (read more)

The National Practitioner Data Bank (NPDB), The "Data Bank"
by Richard Willner on Sunday, January 1, 2012 at 10:13pm ·.

I want to comment on a widespread fallacy about the NPDB that you may not be aware of. Hopefully one day a journalist will introduce this critical distinction into the body of serious journalism on the subject.

The distinction is simply this. The NPDB is not a government database that tracks incompetent or government disciplined doctors, this is a government authorized database of private corporate actions taken against private independent doctors. There is a serious moral hazard here. This is a database of "corporate discipline" with no evidentiary safeguards and no real right of appeal. The entry survives even the physician’s death.  (read more)


Health Care Quality Improvement Act (HCQIA) of 1986. 
What is it? Why was it established? Is it working?
By Richard Willner  

...More importantly, failure to adhere to fair review process can erode the public confidence in the ability of the medical profession to adequately monitor itself.  The AMA further urges all medical staffs to adopt and implement medical staff bylaws that comply with AMA policy II.375-983 as well as the HCQIA.  The following is a list of recommendations to improve upon the Health Care Quality Act of 1986: ...  (read more)

Oldies but Goodies

Readers Response to Bad Faith Peer Review -Bad faith peer review is a crime against patients, physicians, and medicine itself.
Is Peer Review Worth Saving?
Medical staffs need autonomy A California case seeks to protect hospital staff independence --
What Every Physicians Should Know-To use the analogy of a fire, the quicker it is extinguished, the better. The same is true of disciplinary proceedings. At the correction action level, the physician interview is the best tool as it gives the physician the opportunity to discuss, explain, or refute the charges. The physician does not have the right to attorney representation during the interview, but an attorney can be consulted so that the physician is properly prepared. The physician cannot present witnesses in his/her own defense, although documents will generally be received and considered by the committee.
Texas medical board funding will help root out bad doctors -, July 21, 2003
The Shamming of Physicians and Other Providers -excellent newsletter on peer review from Allan Tobias, MD, JD
AAPS Discussion thread on the Center for Peer Review Justice
Have privileges at a Specialty Hospital? Read this!
Do Physicians Have Civil Rights?
Fox Guarding the Hen House
Link To Read from June 9 Issue of TIME Magazine
Due Process or Professional Assassination?
Be ready for battle when you invest - cover story form Healthleaders 12/02
Peer Review May Not Be Confidential When Fairness of Process Is at Issue
AMA Policies Regarding Due Process
Should due process be part of hospital peer review? 
The purpose of requiring due process is to ensure that the actions taken are not arbitrary, capricious, or unreasonable. Where there is no due process, the system invites abuse.
Regarding Dr Gale's Debacle
Good things happen to bad people
The Hunted Physician - Physician discipline is a lot like hunting gazelles in Africa. The strategy and power of the hunter, the hapless innocence of the hunted, and the apathy of the group all visually represent what occurs in most cases of physician discipline.
Specialty Versus General Hospitals and Economic Credentialing
Dr Mc Cord writes on Board Complaints  - If there's any piece of mail that can ruin your day, it's a certified letter from your state medical quality assurance commission or professional licensing board.
Dr Waite, founder of Semmelweis Society speaks on Medical RICO
The Semmelweis Society Meeting - Sham Peer Review
How To Destroy You Competitor  - primer on how sham review is practiced
The Smoking Gun... letter from Senator- There is something fundamentally wrong when a small board of practicing professionals is empowered to decide who should or should not be allowed to go into competition with them.
Statement on the Physician Expert Witness
Battle Ready - What steps can hospital executives take if concerned about the possible encroachment of a competing specialty hospital? (Understanding their strategy can arm you to respond)
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