By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In Part 1 of this blog, I began a list of tips that should serve you well if you are notified by your hospital or medical staff that you are the subject of an internal or external peer review action.
20 Tips For Successful Outcome in Peer Review (Continued):
10. If you are given the opportunity to meet with the reviewers or provide information to them, do so. If you haven’t been offered this, ask for it in writing.
11. Make sure any written response is provided in a typewritten letter formal not via e-mail, text or YouTube posting or handwritten note.
12. In your written statement or response, if you use any abbreviations, spell them out completely the first time you use them and place the abbreviation after, in parentheses. Remember, future reviews of your statement may not be physicians (e.g., a judge) or may not be in your medical specialty.
13. It is never too early to engage experienced health car legal counsel to assist you in such matters. But if you do, make sure you do hire an actual health law attorney who has experience with medical staff peer review actions. This is no place for a plaintiff’s personal injury attorney, a criminal defense attorney or your tax, or business lawyer.
14. If you find out that your matter is being sent out to an external peer review organization you should retain an experienced health law attorney immediately and obtain your own medical expert review.
15. If the care being examined involved another physician as well as you, or if the care was of a patient referred by another physician, see if that physician supports the care you provided and will provide you a letter or statement saying that.
16. If the allegation being reviewed involves facts that you know are not true, see if you can obtain evidence of this. For example, I had a case where nursing staff filed a complaint against my client a male OB/GYN claiming that the mother of a minor female patient had demanded that her daughter only be examined by a female doctor. We are able to obtain an affidavit from the mother swearing that she had never stated that. The peer review matter was dismissed and closed.
17. If it appears that you are being targeted for repeated peer review complaints or investigations, it is time to get out of that place. Read the handwriting on the wall. However, see #1 above. Do not resign with any type of peer review pending.
18. Remember that peer review proceedings are supposed to be confidential. Therefore work through your legal counsel in obtaining outside reviews. Do not discuss the matter with those outside the medical staff.
19. Although the peer-review process is confidential, it is not supposed to be “secretive.” The person who is the subject of peer review should have access to the complaint and medical records involved. This should not be a Star Chamber proceeding. Make a polite written request for copies of such materials or to be allowed to review them and make notes.
20. In many cases, you may find that you did make a mistake, violate a policy or procedure, skip a step in an algorithm, fall below the standard of care, or otherwise screw up. Except in cases of the most egregious situations, your best course o action may be to admit this, explain how this happened, and outline steps you are taking to make sure it does not happen again. This is especially true when it is your first “offense” and you have many years of otherwise excellent performance. The medical staff usually wants to make sure that when a mistake occurs, the health provider has the ability to recognize it and learn from it.
Follow These Tips for The Best Results in a Peer Review Matter.
If you follow these tips, you have the best chance of coming out of the peer review without problems. However, in a really serious case, where many records are being reviewed and the allegations appear to be very serious, then it is most important to retain an experienced health care attorney at the earliest opportunity and take that attorney’s advice. You will be in for the fight of your professional life.
Don’t Wait Until It’s Too Late, Contact a Health Law Attorney Experienced in the Process of Peer Reviews.
If you are the subject of a peer review proceeding, immediately retain experienced, knowledgeable health care counsel to represent you. The attorneys of The Health Law Firm have experience in most, if not all, types of “fair hearings” involving health care issues and health care providers.
At the Health Law Firm, we provide legal services for physicians and other health care providers. This includes nurse practitioners, nurses, dentists, psychologists, psychiatrists, mental health counselors, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers, and acquisitions. We also represent physicians and health care providers in complex litigation in both state and federal courts.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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