Making Committee Membership Attractive

Problem:

“Our physicians are resistant to joining the peer review committee.”

Solution:

To address this fundamental problem, honest answers must be sought to the following questions: Why is there resistance to participate? Is peer review participation known to take a professional toll? Are the committee and its members consistently acting with the highest integrity? What kind of reputation does the committee have? Why do your physicians get involved in peer review and what does this tell you about your program? Are they involved because they have to be or because they want to be?

While peer review is not the only tool available to assess clinical practice, it is one of the most valuable tools when conducted appropriately. But peer review is a two edged sword: When processes are flawed or when peer review is perceived primarily as punitive rather than constructive, both trust and support for peer review are diminished. Despite the critical information it can provide to support quality oversight and improvement, relationships are damaged and the committee’s reputation suffers. Resulting widespread resistance to participation in peer review is a sign that leadership either does not recognize the importance of peer review, or the recognized importance is not matched with appropriate action. In either case, the costs can be immense.

What can hospitals do to help make peer review participation attractive?

1. Give your peer review program the importance it warrants: Given the potential it holds for your hospital and those you serve, your peer review program deserves a significant investment of time, resources and effort. If your leadership is not willing to make the necessary investments, don’t expect much return.
2. Pick the right committee members: Physicians held in the highest regard, those who are widely trusted to do the right thing and who put the interest of patients ahead of their own, and those who treat others as they want to be treated should be the physicians targeted for peer review involvement. Leadership’s challenge is to position membership as an honor and a privilege, to articulate and demonstrate that only those physicians who meet the highest standards will be pursued. Once on board, give members the tools to be successful including thorough, meaningful training.
3. Build your program on a strong foundation: Your peer review program must be built on principles with purpose. See ProblemSolved “Medical Staff Support” for guidance.
4. Communicate: The entire medical staff must be clear on the peer review committee’s purpose and its principles. Regular surveying of medical staff members regarding their perceptions of the committee and its efforts is a valuable tool to measure performance.  If your committee is losing the support of the medical staff, it is losing its effectiveness.

Resistance to peer review committee involvement is a clear indication of peer review dysfunction. On the other hand, when being a member is an honor, when physicians want to participate because such participation is widely held in high regard, and when the committee maintains the support of its peers, benchmark peer review practice can be achieved.