Abstract
Peer review is pervasive. Every physician does it almost every day. Informal peer review activities include discussion of patients among partners, discussion of cases at conferences, and discussions of patients with consultants. Formal peer review activities are less common. Formal peer review activities are those scheduled activities in which review of other physicians’ performance is the principal agenda item. Most physicians participate in them from once a week to once a month. Formal peer review activities include hospital death, tissue, and utilization review and medical audit as well as nursing home utilization review. Certification processes involving peer review include licensure to practice medicine and licensure revocation, specialty certification, educational program (residency training programs) certification, and sometimes hospital and nursing home facility certification. Currently, very little formal peer review occurs outside of inpatient settings except in certain group practices. Because the family physician’s practice is usually predominantly ambulatory, he/ she is less at risk of participating in formal peer review activities than more hospital-oriented colleagues.
Keywords
Quality Assurance Family Physician Cost Containment Utilization Review Quality Assurance ActivityPreview
Unable to display preview. Download preview PDF.
References
- 1.Brook RH, Williams KN, Avery AD: Quality assurance today and tomorrow: forecast for the future. Ann Int Med 85:809, 1976PubMedCrossRefGoogle Scholar
- 2.Brook RH, Williams KN, Avery AD: Quality Assurance in the 20th Century: Will It Lead to Improved Health in the 21st? In Egdahl RH, Gertman PM (eds): Quality Assurance in Health Care. Germantown, Md. Aspen Systems Corporation, 1976, p 3Google Scholar
- 3.Buck CR, White KL: Peer review: impact of a system based on billings claims. N Engl J Med 291:877, 1974PubMedCrossRefGoogle Scholar
- 4.Codman EA: A Study in Hospital Efficiency: The First Five Years. Boston, Thomas Todd Co, 1916Google Scholar
- 5.Cosman MP: Medical practice and peer review in medieval England. Trans Am Acad Ophth Otol 80:293, 1975Google Scholar
- 6.Goran MJ, Roberts JS, Kellogg MA, Fielding J, Jesse W: The PSRO Hospital Review System. Med Care 13:1, April (Suppl) 1975PubMedCrossRefGoogle Scholar
- 7.Hulka BS, Kupper LL, Cassel JC: Physician management in primary care. AJPH 66:1173, 1976CrossRefGoogle Scholar
- 8.Lembcke PA: Evolution of the medical audit. JAMA 199:543, 1967PubMedCrossRefGoogle Scholar
- 9.Peterson OL, Andrews LP, Spain RS, Greenberg BG: An analytical study of North Carolina general practice 1953–1954. J Med Educ 31:1, Dec (part 2) 1956Google Scholar
- 10.Rogers DE: Progress in American Health Affairs: Things Do Change—and Sometimes for the Better. In the Robert Wood Johnson Foundation Annual Report 1976. Princeton, New Jersey, The Robert Wood Johnson Foundation, 1977, p 10Google Scholar
- 11.Sanazaro PJ: The PSRO program: start of a new chapter? N Engl J Med 296:936, 1977PubMedCrossRefGoogle Scholar
- 12.U.S. Department of Health, Education, and Welfare, Office of Professional Standards Review: PSRO Program Manual. Washington, D.C. U.S. Government Printing Office, 1974Google Scholar
- 13.Welch CE: Professional Licensure and Hospital Delineation of Clinical Privileges: Relationships to Quality Assurance. In Egdahl RH, Gertman PM(eds) : Quality Assurance in Health Care. Germantown, Md. Aspen Systems Corporation, 1976, p 180Google Scholar
- 14.Welch CE: Professional standards review organizations —problems and prospects. N Engl J Med 289:291, 1973PubMedCrossRefGoogle Scholar
- 15.White NH, Ryland MA, Giebink GA, McConatha D: Ambulatory Care Quality Assurance Project, Vol I: Development and Application of a Model. Washington, D.C. U.S. Government Printing Office, 1976Google Scholar
- 16.Williamson JW, Alexander M, Miller GE: Continuing education and patient care research. JAMA 201:938, 1967PubMedCrossRefGoogle Scholar
- 17.Wolfe H: Prospective Reimbursement. Inquiry 13:274, 1976PubMedGoogle Scholar