QUESTION

How does the hospital peer review process work?

SHORT ANSWER
The process is governed by each hospital’s medical staff bylaws, but generally involves an investigation and a fair hearing.
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The peer review process is governed by each hospital’s medical staff bylaws. Those bylaws establish the rights and obligations of the hospital and its medical staff to their patients and each other and serve as a framework for the medical staff’s governance of its internal organization and operation. A peer review generally has two phases: an investigation and fair hearing. Investigations are typically initiated by another physician, an ad-hoc committee, or the medical staff’s Medical Executive Committee (“MEC”). The MEC, which is comprised of other physicians, investigates the complaint and interviews the physician. At this stage of the process, the physician’s rights are limited in scope. If the MEC recommends adverse action such as a suspension, modification or termination of privileges, the physician has the right to request a fair hearing.  Depending on the bylaws, this may entail one or more reviews of the proposed corrective action including a review by a fair hearing panel.  The fair hearing panel provides the physician with certain procedural due process rights including, among other things, the right to present evidence, examine and cross-examine witnesses, and the right to counsel.  The medical staff bylaws typically allow a final appeal of any recommendation by the fair hearing panel or the MEC’s decision to the hospital’s governing board.

A careful review of the particular bylaws by experienced counsel is an important first step in evaluating the best course of action to take in your case. If you are a physician subject to peer review, or a facility initiating one, ASG Law can help you develop and implement an appropriate strategy.