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February 16, 2000

The National Practitioner Data Bank and the Quality of Peer Review

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor


Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2000

JAMA. 2000;283(7):886-887. doi:10.1001/jama.283.7.882

To the Editor: The article by Dr Baldwin and colleagues1 and the accompanying Editorial by Dr Brennan2 fail to note that in small hospitals where physicians wear many hats (peer review, credential committee, service chiefs), physicians must hide behind the curtain of confidentiality by either perjuring themselves or making credentialing a sham. As a member of a credentials committee, one is required to state that there is no knowledge of information that might have an adverse effect on the application. Since the board of trustees ultimately determines privileges based on recommendations of the credentials committee (whose decisions reflect administrative or peer review recommendations), withholding peer review information will reduce the reporting to the National Practitioner Data Bank (NPDB). This is particularly true when peer review involves retrospective evaluations over periods longer than 2 years. In such instances, a physician may be recredentialed twice without jeopardy and no reporting to the NPDB will occur.

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