When the outcomes of a case are not as good as anticipated, the standard approach to assessing whether the care that was provided was appropriate is through morbidity and mortality conferences or, if there is a higher level of concern, through a peer review process. These assessments of care are typically done within a departmental or specialty structure. The sociologist Eliot Freidson,1 who studied medicine as a profession, argued that there was a built-in tendency to protect the profession over other interests. We believe that this risk for bias may be high within specialties that are eager to maintain their reputation in a hospital and community.
Nurok M, Gewertz B. Interdisciplinary Disease-Based Peer Review: Moving Quality Assurance Into the Future. JAMA Surg. 2018;153(1):3–4. doi:https://doi.org/10.1001/jamasurg.2017.3809
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