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"Good things to happen to bad people." 

Politics and money corrupt medical peer review. They thwart the interests of the public and the profession. 

This situation will cost us all time, trust, and treasure as long as "mere administrative" proceedings conceal libel on the peer review committee. Would Federal laws requiring Due Process in Peer Review save patients' lives and money, and physicians' sanity? 

It is a jungle out there. The saying in business is that "Bad Money Drives Out Good." You complete 25 years of education to enter practice, only to find that hard work is not always compensated. Someone else is telling you that his arbitrary rules apply. He threatens through an undemocratic committee to control your income and job security. Is this covert slavery--corporate, competitive, or both? ...  Even if the laws never change, doctors entering practice or re-locating--even medical students considering various scholarships--can make informed choices with knowledge of the terrain ahead of them. They can avoid "buying a first-class ticket on a wonderful train tour to the EAST on the finest rolling stock available" (as advertised in BERLIN during the War. The trains entered the camps.). 

First, peer review committee members must be PEERS--doctors practicing in the same specialty who therefore understand what is being said. 

Second, the doctors must be INDEPENDENT. As Dr. Edwin Day stated eloquently on his superb web page that was formerly at SemmelweisSociety.org, anything else is a sham. Established physicians on the committees can effectively grant themselves and their friends immunity from prosecution for libel. This conduct is racketeering. Could it be stopped by a Medical RICO Act requiring due process in medical peer review? 

Is there a less-cumbersome approach? (Remember, every medical dollar spent on a non-medical salary detracts from the care you receive--how many "K-Mart greeters" and "health-education promoters and coordinators" do you want to support before you finally get to the doctor at the back of the store?) 

Would a law abrogating the right to sue for libel in exchange for impartial peer review be acceptable, or would it be suicidal, a unilateral disarmament? Do we really need the equivalent of a "civilian review board" to take on the corruption of the present peer review boards, or
can we institute impartial peer review quietly and responsibly? 

Third, there is every reason to regard the Credentials Committee as de facto peer review, even though its claim to fairness in that regard is often polluted by the presence of non-physicians who promote themselves with either a personal, a monetary, or even a private psychological purpose... 

The Credentials Committee should not be accepted as the peer review committee because an independent committee is needed. 

Fourth, even when the peer review is in the doctor's favor, politics can turn the situation sour. This country is not as free as it advertises itself to be. 

Read this article on peer review published in April, 2001: http://www.uoworks.com/content112.html.

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