Peer reviews refer to the processes through which the performances of doctors and other medical staff are reviewed by other doctors, health care providers, and hospitals. In Texas, the peer review process is governed by Section 160.007. This section outlines the Texas Occupations Code. According to this legislation, the activities of the peer review committee are “confidential, and any communication made to a medical peer review committee is privileged” (Riney & Wolek, 2007). Unlike in other States, the peer review law of Texas covers broad issues. Dr. Reed is governed by all of these statutes and her next course of action has to be within the statutes’ stipulations.
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The other legislation that touches on Texas’ peer review processes is the Health and Safety Code. The Texas Health and Safety Code stipulates that “The records and Proceedings of a medical committee are confidential and are not subject to court subpoena” (Riney & Wolek, 2007). This law minimizes Dr. Reed’s options when it comes to getting her complaints before a Judge. The only exception to the confidentiality of the records of a peer review process is if a judge rules that the process was subject to anticompetitive and/or civil rights issues.
Therefore, Dr. Reed can still get her complaints heard before a judge. In addition, Section 160.007 Clause C of the Texas Occupations Code makes it possible to disclose the proceedings of a review committee to selected entities. These entities include “relevant state agencies, national accreditation bodies, the state board of registration or licensing of physicians of another state, or another peer review committee” (Watson & Anderson, 2010). Dr. Reed has the option of tabling her concerns to any of these entities instead of seeking redress in a court of law. Resolving the issue through the avenues stipulated by the State Code consumes less time and resources.
The federal law that outlines peer review laws is covered by the “Health Care Quality Improvement Act (HCQIA) of 1986” (Kinney, 2009). The Act protects the participants of a peer-review process. On the other hand, this law offers Dr. Reed the right to cross-examine her reviewers, question their motive, and present her evidence. Hospitals have established various measures to mitigate the effects of malicious peer reviews. Therefore, Dr. Reed would have a hard time proving the hospital’s liability. Malicious reviews are also referred to as ‘sham reviews’ and they are usually used by hospitals to victimize ‘disruptive’ doctors.
If Dr. Reed’s concerns fall under this category, she has to present evidence that makes the hospital liable. Establishing a hospital’s liability is usually an uphill task. In 2005, the Supreme Court in Texas ruled in favor of a hospital that was being sued over a malicious peer review. In Romero v. KPH Inc, the hospital was sued for ignoring a surgeon’s drug addiction during the peer review process (Watson & Anderson, 2010). The Court cited insufficient evidence in its ruling. In Reed’s case, the hospital might deny her medical practitioner privileges as a mitigation measure. Consequently, Dr. Reed has to prove she does not have any liabilities in her professional conduct that might be transferred to Memorial Hospital.
Given the current federal and state statutes, Dr. Reed would have a hard time proving that the peer review committee denied her privileges unfairly. The state of Texas has put in place a set of laws that ensure that both Dr. Reed and the Memorial hospital committee are protected from malicious peer review practices. The federal laws on the other hand give Dr. Reed a better chance of disapproving the committee’s decision. It is up to Dr. Reed to present her case in a manner that does not contravene either state or federal laws.
Kinney, E. (2009). Hospital peer review of physicians: Does statutory immunity increase risk of unwarranted professional injury. Michigan Medical Journal, 3(1), 57- 60.
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Riney, T., & Wolek, C. (2007). Hippocrates enters the new millennium- Texas medical privileges in the year 2007. Texas Law Review, 41(3), 335-336.
Watson, J., & Anderson, M. (2010). The medical peer review privilege: Illustrative cases of the public policy supporting the privilege and a practical approach to presenting the case for protection. Trials & Institutions, 95(2), 204-209.