The Semmelweis Society. Unbiased Medical Peer-Review.
Career Protection
M.D. - Attorneys
Contract Review
By-laws Review
Doctors' Data Bank

     Where did 'Peer Review' originate?   What is its legal status?  Is it required?   If we already have M&M Conference and other conferences to improve care, what is  'peer review'?   If  'Better medicine' is the purported purpose of peer review, by which standards should it be conducted, and by whom, to protect patients and competing physicians?  
    The randomized controlled double-blind trial is a standard of judgment, not because it assures accuracy, but because it defines the limits of error.
     In a society with constant competition, personal bias is inevitable when co-workers judge each other (See Scott Segall's first article on the Home Page.). 
     Good-faith usually accompanies medical 'outcomes', including unfortunate outcomes such as death.  The purpose of peer review should be to educate in good-faith how to reduce error and advance knowledge. 
     Bad-faith peer-review is a witch-hunt for profit, such as a vindictive  M&M conference.  To the degree that doctors fear discussion, learning is limited.   
     Remember, there was a time in our medical history when knowledge was suppressed, for example when the secrets of obstetric forceps were 'closely-held' for private profit.

Enter supporting content here

Would you prefer this to the present system:
What if...hospitals, HMO's, and, yes, physicians were invited to agree to unannounced, random peer review?  Would it be worth the effort?  The inconvenience?  The 'exposure'?  Would there be less administrative waste?  Better care?
     As things now stand, hospitals conduct a paper shuffle for their triennial JCAHO certification.  Peer review is often a political witch hunt to find someone upon whom to stick a (mandatory?, by quota?) Category - 4 designation.  What if inspections were random, unannounced, and confidential to encourage participation for patient safety? 
     There is at least one suggestive precedent:  Fein, E:  "12 New York hospitals receive surprise visits from state inspectors."  NY Times, March 12, 1998, Section B, p.1.