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'A foolish consistency is the hobgoblin of little minds.' Emerson
There are many ways to conduct fair peer review. It should be a local option, clearly stated and understood by all doctors considering to join a practice. Some would argue that ideally review would be prospective, informative and 'constructive' rather than punitive. One model is printed below. If you prefer another method, send a link to what works for you HButler@POL.net
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In almost every setting where important decisions turn on questions of fact, due process requires an opportunity to confront and cross-examine adverse witnesses. E. g., ICC v. Louisville & N. R. Co., 227 U.S. 88, 93 -94 (1913); Willner v. Committee on Character & Fitness, 373 U.S. 96, 103 -104 (1963). What we said in [397 U.S. 254, 270] Greene v. McElroy, 360 U.S. 474, 496 -497 (1959), is particularly pertinent here:
"Certain principles have remained relatively immutable in our jurisprudence. One of these is that where governmental action seriously injures an individual, and the reasonableness of the action depends on fact findings, the evidence used to prove the Government's case must be disclosed to the individual so that he has an opportunity to show that it is untrue. While this is important in the case of documentary evidence, it is even more important where the evidence consists of the testimony of individuals whose memory might be faulty or who, in fact, might be perjurers or persons motivated by malice, vindictiveness, intolerance, prejudice, or jealousy. We have formalized these protections in the requirements of confrontation and cross-examination. They have ancient roots. They find expression in the Sixth Amendment . . . . This Court has been zealous to protect these rights from erosion. It has spoken out not only in criminal cases, . . . but also in all types of cases where administrative . . . actions were under scrutiny." |
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1. Prospective, random selection of cases: Political neutality, a built-in 2nd opinion before treatment.
2. Impartiality is the essential ingredient. No doctor will join a medical entity which fails to appoint unbiased peers (from outside the jurisdiction, and acceptable to all parties) to judge cases.
3. A jurisdiction establishs its own rules, whether by county, by specialty, by group, medical staff, etc.
4. Random rotation of administrative duties among different doctors also abets impartiality.
5. If an error (judgment, technique, etc.) is judged to have been avoidable, emphasis should be on education as restitution.
6. Character defects (addiction, coercion, dishonesty) are not matters for peer-review per se; they can be addressed as non-professional but important, legitimate legal issues in another forum, such as by the elected (not appointed) president of the medical society..
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