Doctors “Disciplining” Doctors? Don’t Get Your Hopes Up

White House

Health Care (2199832) a subgroup of the White House

Patrick McDonald – response to the article, “How Do We Improve the Quality of Hospitals?”


As a 30-year Paramedic, I can attest to the failure of physician peer review process. It is often an ugly joke in many medical programs. The director of peer review is a hospital-employed MD, for one thing. Every veteran big-city medic I know has witnessed incompetent – sometimes criminal – physician practice, which has had devastating outcomes for patients and families. When that happens, both nurses and medics perform mental and emotional backflips before detailing incident reports pointing out exactly who did what. We know we may well be committing professional suicide.

As I say. Ugly.

The errant physician may – although it is not likely – be brought before his pals on the review board. They will assure their friend that this too, will pass, and they look the other way. The business of moving patients in & out goes on as usual. Too often, peer review is a closed club and they protect their own – even as they know the truth. After all, “There but for the grace of God . . .” – it could be themselves next, and they would surely hope that they could count on their peers to stonewall anything that smacks of transparency.

The function of peer review is not – as it is meant to be – a dependable mechanism to improve hospital performance standards. Neither is it an objective learning experience for the physician. It does – occasionally – document future liability for a hospital. But these records are sealed and almost never forwarded to the National Practitioner Data Bank, as mandated by law.

And that failure of hospitals to self-report – in and of itself – underscores much of what we need to know about medicine’s stubborn refusal to properly police its own.

The fact is, Paramedics and nurses work closely in many programs with our physicians and we don’t want to see anyone fail either. In the end, however, we are often the patient’s only advocate. We are also at-will employees and frequently threatened by EMS authority, if we dare talk. So few of us do.

In my view, peer review for doctors must become an independent 3rd party entity. The conflict of interest in the current model is obscene. I am simply damned tired of watching in silence, as incompetent, immoral physicians repeatedly blunder, time after time; self-refer patients in order to pad family/friends’ wallets; perform thousands of unnecessary surgeries; push billions of dubious drugs – in short, cause the very harm they swore to prevent.

Consider this fact for a merely 30 seconds, please:

Errant healthcare will almost assuredly kill more than 2,000,000 citizens between today and 4th of July, 2025.

You may want to go back and ogle all those zeros.

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