QUESTION:
One of our physicians has been asked to attend a peer review meeting to discuss several cases that raised concerns. The physician has informed us that she intends to bring her attorney to the meeting. Are we required to allow legal counsel to attend?
ANSWER FROM HORTYSPRINGER ATTORNEY FISHER FILIPPAZZO:
This is a great question and one that comes up frequently during the peer review process. As a general rule, physicians do not have a right to bring legal counsel to routine peer review meetings unless that right is specifically provided by the Medical Staff Bylaws, peer review policy, or applicable state law. Also, if a physician will not be permitted to be accompanied by counsel, the hospital attorney should not attend either.
It is important to remember that a routine peer review meeting is not the same thing as a formal hearing. Peer review meetings are intended to be collegial discussions among physicians regarding clinical care, opportunities for improvement, and any concerns that have been identified. Allowing attorneys to participate can quickly change the nature of the discussion and make it more difficult for the committee to conduct an effective review.
Sometimes physicians express concern that the outcome of the review could ultimately affect their privileges. While that concern is understandable, hearing rights, including any rights related to legal representation, are typically triggered only if a professional review action reaches a stage where formal procedural rights apply. In most organizations, a routine peer review meeting is simply a step in the information-gathering process.
That does not mean the physician is unable to present information. The physician can be invited to submit a written response, provide supporting documentation, or otherwise address the concerns raised by the committee. In fact, committees often receive the most helpful information when discussions remain focused on the clinical issues rather than legal arguments.
For these reasons, hospitals should review their Medical Staff Bylaws and peer review policies to ensure they clearly address whether attorneys may attend peer review meetings and apply those provisions consistently.
If you have a quick question about this, e-mail us at info@hortyspringer.com.