Under the pretext of “protecting patient safety,” a hospital or other medical facility can permanently end an excellent physician’s ability to practice his profession, writes New York neurologist Lawrence R. Huntoon, M.D., Ph.D., in the winter issue of the Journal of American Physicians and Surgeons.
All that it takes is an Adverse Action Report (AAR) in the National Practitioner Data Bank (NPDB), he explains. An AAR is filed by the hospital if a physician is sanctioned in some way as a result of a “peer review” proceeding—which may be a “sham peer review” conducted in bad faith for reasons unrelated to quality of patient care. Reasons may include a physician’s complaint about a patient-safety issue, opposition to the organizational agenda, or anti-competitive motives. Physicians have few due-process protections.
Negative consequences of an AAR include inability to obtain or renew medical staff privileges, inability to obtain or renew a medical license, inability to obtain employment as a physician, termination of medical liability insurance, termination of participation on insurance panels, severe limitation on where a physician might be able to practice (e.g. restricting opportunities to remote areas of the country), and inability to continue practicing in one’s specialty, Dr. Huntoon writes.
Because of legal immunity granted to entities performing peer review in the Health Care Quality Improvement Act of 1986 (HCQIA), it is extremely difficult for physicians to challenge an adverse action successfully, he states. An AAR can only be removed by the reporting entity.
“The mechanisms for inflicting damage on the physician victim’s career include blacklisting, rumor, smears, blackballing, and a tactic similar to extortion.” Severe long-term stress, depression, and suicide may result.
“Few physicians fully understand the total destruction of a medical career caused by a sham peer review, unless it happens to them or someone they know,” Dr. Huntoon states.
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.