Medical Staff Support

Problem:

“Our peer review efforts are not well supported and are often resisted by our medical staff.”

Solution:

Lack of physician support for peer review usually comes either from a lack of understanding, lack of trust or both. These culprits stem from a historical lack of attention to the very foundation upon which peer review activities must be grounded. Physician leaders involved in peer review must first trust each other–and then build trust among their medical staff peers by engaging in meaningful dialogue around the following questions:

1. What kind of culture do we want as a medical staff? How does this compare to what we have? What will we do about the gap?
2. How can we show respect for each other and our colleagues while ensuring that our physicians are providing the best care possible?
3. What are the principles upon which our peer review will be based? What is the purpose of our peer review efforts?
4. How do we each want to be treated as committee members and if we are the subject of peer review?
5. What are our responsibilities as leaders?
6. What are the standards to which we and our colleagues will be held?
7. How will we build and maintain medical staff support?
8. How can we stay constructive and collegial?
9. How will we know if we are performing well?

Too many medical staff leadership teams never even acknowledge the importance of these questions and can’t imagine taking the time to address them. They see their committee roles as cumbersome and intrusive-a chore-rather than as highly valuable and critically important to patient care. As such, physician leadership activities are often built on the most shaky ground and run by people who would rather not participate but have to. Participating physicians perpetuate the same culture that erodes trust rather than building a new foundation upon which trust, respect, sensitivity and meaningful outcomes are possible. Taking the time to reach clear consensus on the answers to the above questions will help build the principles that guide peer review activities going forward. When widely understood and accepted principles serve as the foundation for policy, procedure and consistent behavior, peer review can shed itself of unhealthy stigmas and come to be embraced for the potential it holds for everyone involved.