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November 4, 1983

Making Peer Review More Productive

Author Affiliations

From the Department of Health Care Administration, Baruch College, and the Department of Health Care Management, Mount Sinai School of Medicine, City University of New York, New York (Dr Rosen); and the Section of General Medicine, Department of Medicine, the Hospital of the University of Pennsylvania, Philadelphia (Dr Sussman).

JAMA. 1983;250(17):2305-2306. doi:10.1001/jama.1983.03340170031023

PEER REVIEW is the time-honored approach to the assurance of quality medical care. As pressure for the accountability of the medical profession has increased, participation in peer-review activities has often been characterized by physicians and hospital managers as a burden and a time commitment that is less than productive. However, it is a time commitment that physicians and hospitals will most likely be unable to avoid regardless of legislative or other changes. More importantly, effective peer review requires systematic clinical judgments that only physicians can provide. Insights drawn from information system theory might improve the peer-review process, thereby using the time invested more effectively.

The burdensome aspects of peer review are the result of two forces. The first is the medical profession's tradition of autonomy and confidentiality in peer review. This tradition has resulted in private committee discussions and frequent recommendations for actions to department chairmen or medical boards. The