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


by Richard Willner, CEO
The Center for Peer Review Justice

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. This type of information only reflects negative findings once a review is initiated, which does not enable patients to make informed decisions. However, the means by which health care quality is assessed is changing.

What implications will the health information revolution have for the health care regulatory framework? One possible answer is that the health information revolutions should prompt us to regulate less. A patient with access to information about individual provider's quality of care, for example, would have less need for state medical boards assistance in rooting out poor quality providers . . .. A second possible answer is that the health information revolution should prompt us to regulate more. Information imperfections will persist forever, so regulation can at least potentially benefit some patients. Because information about quality is an input into the regulation process, and technological innovation has reduced the cost of such information, we can regulate more cheaply than we once could. Kristin Madison, Regulating Health Care Quality in an Information Age, 40 U.C. Davis L. Rev. 1577 (2007).

The question as to whether more openly available information will best serve the interest of patients, or whether this availability will afford a new and improved means of effectively publicizing a sham peer review is not clear. In a Utopian sense, if the actual quality of the provider's services were available in an unbiased manner, patients would indeed be armed with an effective tool to assist them in finding the most suitable provider for their needs. Unfortunately, the real world of kangaroo courts and sham reviews destroys this ideal. The public is informed, of course, in terms of what is reported to the National Practitioner Data Bank and in the form of board orders. This does not insure the information is factually correct, especially when the individuals providing the information to the data banks have immunity and may have pecuniary interests in the information provided. Thus, the present form of providing information to the public to improve the public safety and welfare is significantly flawed.

A hypothetical patient that moves to a new city may seek information as to which provider they should see for a given need. In Utopia, the patient could find information regarding providers with the highest ratings for various services or conditions. Instead, in Real America, the patient sees only the names of the providers who remain on staff at the facility of choice without knowing who might be better for their given need. The best provider, in fact, may not be listed due to a sham review that removed that provider from the staff; hence, the patient would never be aware of that provider. Perhaps, the economic interests of those in control of the peer review process came ahead of maintaining the best provider on the staff. Perhaps, a negative report was generated against the provider that would have best served the patient's needs, which obviously places the provider on the DO NOT USE list for services to the average patient. The average person looking to receive healthcare does not understand the intricacies of sham peer review versus genuine reviews based on true competency and safety concerns. This is Real America, not Utopia. Sadly, this can and does happen.

Until an appropriately regulated Utopian informational system becomes available, sham peer reviews will continue. There is a solution. The Center for Peer Review Justice can manage the sham peer review defense and help with the abuse from the State Medical Boards.
 

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