From Medscape General Medicine™ Letters Readers' Responses in Regard to "Sham Peer Review"   Posted 02/02/2006 Mark F. McDonnell, MD; Lawrence R. Huntoon, MD, PhD, FAAN; John Majerus; John Wright, MD, FRACS, FACS

I read with interest the recent article on sham peer review.^[1] I was even more interested in the recent editorial by Mr. Bond on the same topic,^[2] because it suggests a very plausible motive for sham peer review to occur, namely, economic domination of the physician community.

It is obvious that an independent physician community is the greatest economic threat to the health insurance-hospital industrial complex. Good doctors are especially dangerous to this conglomerate, because they put their patients' interests ahead of the dictates of managed care or of the local hospital's economic success. As Mr. Bond elucidates, this health insurance-hospital industrial complex initially tried to control physicians by purchasing their practices but found that the good doctors cannot be bought. The "final solution" seems to be to eliminate troublesome doctors altogether, with sham peer review as the ultimate weapon. Denying care to our patients apparently was just not profitable enough.

I also would strenuously object to this term of "sham" peer review as being much too mild. With the heinous level to which all of this activity has risen, I think that the term "bad faith" peer review (with all of its legal implications) better describes the situation and should be used exclusively. Victimized physicians need to organize and strike back against the bad faith actions of the health insurance-hospital industrial complex and its minions. Moreover, all physicians must become informed of this latest attempt to dominate medicine and must support their victimized colleagues. Bad faith peer review is a crime against patients, physicians, and medicine itself.

Mark F. McDonnell, MD
Houston, Texas
mfmcdonnell@stpsinc.com

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