Medical Peer Review - Composition of Peer Review Boards

Composition of Peer Review Boards

There is no one standard composition of Medical peer review bodies, nor are there different names for peer review bodies of varying constituent parts. They may be carried out by State medical boards (with different standards for membership), hospital administration, senior staff, department heads, etc., or a combination of these.

State medical boards conduct peer review of licentiates, composed of physicians only or including attorneys and other non-physicians, varying by state. Physicians may be board members in primarily advisory capacities. Medical peer review may be carried out by committees that may include physicians not on the board. The same is true of state boards run by physicians from that state; board physicians or physicians unaffiliated with the board may be in medical peer review committees.

In hospitals, only a peer review committee authorized by the physician medical staff is authorized to take action regarding a physician's medical privileges at that institution. A committee convened by the hospital administration or other group within the hospital may make disciplinary recommendations to the physician medical staff.

Departmental peer review committees are composed of physicians, while hospital-based performance-appraisal and systems-analysis committees may include nurses or administrators with or without the participation of physicians.

Although medical staff bodies utilize hospital attorneys and hospital funds to try peer review cases, the California Medical Association discourages this practice; California legislation requires separation of the hospital and medical staff.

Nursing professionals have historically been less likely to participate or be subject to Peer Review. This is changing, as is the previously limited extensiveness (for example, no aggregate studies of clinical nursing peer review practices had been published as of 2010) of the literature on nursing peer review

In response to the Health Care Quality Improvement Act of 1987, (HCQIA) (P.L. 99-660 ) national medical associations' executives and health care organizations formed the non-profit American Medical Foundation for Peer Review and Education to provide independent assessment of medical care.


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