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Tip of the week: Create a list of external peer reviewers

Medical Staff Leader Connection, April 13, 2007

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It is wise to have potential external peer reviewers in mind because the need for them can arise without warning. A good external peer review organization should provide the following:

• Board-certified, clinical consultants in all specialties, currently active and located outside the geographic area of the physician under review. Note: External peer reviewers do not need to be privileged by the facilities that use their services.
• The ability to ensure that the physician reviewer has no knowledge of or connection to the physician being reviewed.
• A good track record of consulting experience in the area of medical record review.
• The ability to provide a professional final report in a timely manner. Note: After receiving an external peer review report, do not have a specialty department vote on its acceptance, as doing so raises the specter of anticompetitive intent and can provide credibility to an antitrust lawsuit. External peer review results should be accepted and acted on by a medical staff credentials or quality committee or by the MEC per hospital policy.
• The ability to defend and support their findings if a subsequent fair hearing or litigation ensues, including testifying, if necessary. They should also be willing to participate in conference calls to clarify their report, if necessary.
• The ability to commit to absolute confidentiality and strict nondisclosure. Provisions pertaining to confidentiality should be discussed in advance and included in the contract language.

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