The Peer Review Privilege for Office-Based Physician Practices (Part 2)

November 12, 2010, 2:50 PM

To take advantage of the available peer review and quality assurance privilege, your practice needs to ensure that the committee and process are developed in accordance with the statute. To qualify, your practices committee must be established pursuant to guidelines approved or adopted by (a) a national or state peer review entity, (b) a national or state accreditation entity, (c) a national professional association of health care providers or a Virginia chapter of a national professional association of health care providers, (d) a licensee of a managed care health insurance plan (MCHIP) . . . or (e) a statewide or local association representing health care providers licensed in the Commonwealth . . . .

Thankfully, the Medical Society of Virginia (MSV) has published Quality Assurance and Peer Review Guidelines. The MSV Guidelines outline a two-tiered approach of random reviews along with reviews of reported incidents. As guidelines adopted by a statewide association representing physicians licensed in the Commonwealth, your practice may establish its peer review/quality assurance process pursuant to the MSV Guidelines and qualify for the statutory protection. There are certain beneficial modifications we can suggest to tailor the process to your practice and to afford even greater protection.

A carefully developed policy establishing your peer review/quality assurance process according to prescribed and recognized guidelines, modified as appropriate to meet the needs of the group, can prove immensely beneficial to patient safety and quality of care, without compromising the groups legal position in litigation relating to any areas that the committee has addressed. This privilege can bring enormous benefits in the protection of sensitive information from litigants or members of the public, and the practice can realize the advantages of improved patient care that thorough and regular peer review has to offer. All practices that have not adopted an official written Peer Review and Quality Assurance Process should strongly consider doing so. --Jason R. Davis