How to resolve peer review and credentialing conflicts with physicians:

Although doctors are usually protected in hospital peer reviews, the process can be a challenging and complex one, and may not have a positive outcome. For this reason, resolving peer review and credentialing conflicts with physicians, often requires the intervention of legal counsel.

Reasons for Conflict

Physicians, who believe that they are adequately credentialed and competent, often feel that they are unfairly treated by a peer review. As a result, some of them become frustrated by the process, and opt to resign in the midst of the investigations.

Resolving Conflict

When peer reviews are presented in an educational rather than a disciplinary context, less conflict is likely to arise. Physicians should therefore be advised of hospital policies and procedures, and their expectations in this regard.

The hospital should also have a clear peer review policy that outlines the role of peer reviews in maintaining standards, and quality of care. Peer review committee members should be adequately trained, and have the specialized knowledge to carry out their task in a timely manner. In addition, the findings should consist of objective evaluations that are clear and consistent.

This approach can help to quickly diffuse potential conflict. However, there are times when the process is not properly executed, and the physician decides to seek legal representation to resolve conflict. The physician should choose a law firm that specializes in health care matters, and has the expertise to handle peer review and credentialing issues.

The attorneys at Nelson Hardiman, LLP have represented physicians in a number of peer review actions in California. Our success in gaining landmark decisions in relation to physician rights is evidence of our expertise in these matters.  Call 310-203-2800 today for an appointment.

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