The Health Care Quality Improvement Act of 1986 and Physician Peer Reviews: Success or Failure?

 The following abstract is from an article that can be retrieved from  http://www.allianceforpatientsafety.org/articles.php (website: Alliance for Patient Safety) I could not retrieve it anymore from the original site  http://www.usd.edu/elderlaw/student_papers_f2003/health_care_quality_improvement_act.htm

The Health Care Quality Improvement Act of 1986 and
Physician Peer Reviews: Success or Failure?
By: Bryan G. Hall

The Master Said to Narendra:
“Have you become an experienced physician?”
Quoting a Sanskrit verse he said, “He who has killed only
a hundred patients is a novice in medicine;
but he becomes an expert after killing a thousand.”
- Ramakrishna

Abstract

In the early 1980’s, in response to numerous newspaper articles reporting cases of physician ineptitude, the medical community increased its efforts to limit the practice of incompetent physicians through the implementation of professional peer review and credentialing procedures for a physician’s obtaining of hospital privileges and membership.  However, as the decade progressed, the success of the peer review
process became hindered by an increase in lawsuits filed by the disciplined physician against the individual review committee and hospital.  In response to this increase in litigation, the Health Care Quality
Improvement Act (HCQIA) of 1986 was passed by Congress with the expectation that it would help protect hospitals and individual’s participating on medical peer review committees from potential liability in the form of money damages after the revocation of a physician’s hospital privileges. The Act has established standards for the hospital peer review committees, provides immunity for those involved in peer review, and has created the National Practitioner Data Bank, a system for reporting physicians whose competency has been questioned or when the physician has been sanctioned.

The effect of HCQIA on many of those that have been on the receiving end of a bad faith peer review committee has been unjust and unfair. Critics argue that the HCQIA helps foster an environment in the
medical community that, instead of promoting the goal of quality health care in America, allows the peer review process to be perverted for political and economic motives. This report will analyze the current peer
review process and the importance of hospital privileges, the standards and immunity provided by the Health Care Quality Improvement Act, as well as a critique of the Act regarding its protection of bad faith or
malicious peer review committee. This report will also offer some suggested remedies in order to ensure a more equitable and just peer review system and thus help realize the primary goal of the Act, the
implementation of the best quality health care system possible.