Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
In Reply: Dr Frable illuminates the conflict
that rural (and urban) physicians can experience when they serve as members
of their hospitals' credentialing committees, reviewing the performance of
physicians who are their business partners, referral sources, and friends.
The conflicts of interest inherent in more intimate, rural health care systems
provide strong barriers to the peer review process. Recognizing this, a consortium
of 43 Iowa hospitals developed a provider-based statewide physician peer review
program.1 This collaborative demonstration
project of the Institute for Quality Healthcare, the University of Iowa, and
The Robert Wood Johnson Foundation provides hospitals with the opportunity
to use specialty-specific physician peer reviewers from outside their own
staffs to conduct reviews. Developing anonymous internal reporting systems
along with external review such as that developed in Iowa may help overcome
the barriers that many hospitals experience with their peer review processes.
Baldwin L, Hart LG, Fordyce MA, Rosenblatt RA. The National Practitioner Data Bank and the Quality of Peer Review—Reply. JAMA. 2000;283(7):886-887. doi:10.1001/jama.283.7.882