Practicing medical professionals who are contending with an upcoming hospital peer review will have several questions regarding the process, and whether or not legal counsel should be retained. Moreover, the peer review process does have the potential to derail a physician’s medical practice and can additionally tarnish a physician’s reputation.
The consequences of a peer review process may include reports being filed with the Texas Medical Board, and can also lead to disciplinary action. The negative ramifications of a hospital peer review can also result in reports to the National Practitioner Databank (NPDB), which can then expose a physician to review by other hospitals where he or she holds privileges, and by insurance carriers. An insurance carrier review can result in the physician being removed from his or her provider network.
Peer Review Due to Allegations of Unprofessional Behavior or Standard of Care Complaint
It is important for a physician who is contending with these types of allegations to understand the peer review process and its potential outcomes. Often, the consequences are greater than whether or not he or she will be able retain hospital privileges. Most physicians find that retaining legal counsel early in the process is one of the key elements to building their defense.
Peer Review Investigation and Fair Hearing
Generally, a peer review investigation consists of two stages—an investigation followed by a fair hearing. Each hospital’s medical staff bylaws will detail the procedural details of the fair hearing, and will also define the rights of the physician to participate in the investigation.
Investigations are typically triggered by a medical error outcome regarding patient care or complaints about a physician's behavior or professional conduct. In a situation where there is a potential for a physician’s continued practice to pose an imminent threat to a hospital's patients or staff, a hospital medical executive committee may issue an immediate suspension of a physician’s privileges while the investigation is pending.
Even a temporary suspension of hospital privileges can severely damage a physician’s reputation and the viability of his or her practice. In the event that a suspension lasts longer than thirty days, the hospital is required to submit a report to both the Texas Medical Board and the NPDB.
Consult with a Knowledgeable Texas Attorney Today
If you are a physician who is navigating the peer review process, having a skilled attorney at your side can help you defend yourself to the best of your ability. Potential peer review results and ramifications can be serious and may have a significant negative impact on your practice. However, an experienced Texas professional license defense attorney can help you navigate the review process and minimize the potential for negative impact on your career. Contact Oscar San Miguel, Attorney at Law, for a consultation today.