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cenario: A neurosurgeon is claiming injury and damages from a for-profit hospital that notified him that...

cenario: A neurosurgeon is claiming injury and damages from a for-profit hospital that notified him that it had denied his hospital admitting privileges. The physician claims the hospital used its peer-review process as a veil to deny access to the hospital and his subsequent ability to perform surgeries. Shortly after, the neurosurgeon began performing surgeries at an academic medical center where he was also named as Chair of Neurosurgery. The for-profit denies any misuse of its peer-review process and bases its decision on the multiple claims brought by other physicians and patients that the neurosurgeon was over treating patients in order to make more money for himself.

The options for resolving this issue include defending the suit in court, going to arbitration, going to mediation, or structuring a settlement.

  1. What are the advantages and disadvantages of each resolution?
  2. When addressing the hospital board of directors, what option would you recommend? Why is your recommendation the best option?
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Answer #1

1. Medical peer review is one of the primary means of ensuring quality patient care within the medical profession. Peer review involves examining the credentials of physicians applying for staff privileges within a hospital, as well as monitoring the quality of patient care given by physicians who already possess staff privileges. Confidentiality is essential to meaningful and effective peer review. Without the protections of immunity and confidentiality that peer-review statutes afford, physicians may be reluctant to serve on peer-review committees or to conduct meaningful peer reviews. Peer-review statutes enable physicians to identify problems in their peers' performance and to take appropriate remedial steps without the fear of retributive lawsuits or other negative consequences.

The goals of peer review are to prevent malpractice and ultimately improve the condition of health care. Doctors participating in peer review can recommend that the hospital board terminate or reduce the scope of the reviewed physician's privileges to practice at the health care facility. In addition, peer review committees can recommend training, education, or monitoring to improve the reviewed physician's deficiency. Although some questions surround the effectiveness of peer review, an increased concern for quality health care has resulted in both state and federal legislation to protect the peer-review process.

*The Director can take out a policy to recompensate the loss he suffers because of his liability to the company. The premium for such policy may be paid by the company itself.

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