Secret doctor meetings and their implications

¶ … Confidential

The evolution of the medical industry has brought about many changes in the way that people live their lives and maintain their health. The large dependence upon medical professionals by people seeking medical advice has placed both of these parties in a unique situation where the trust between patient and doctor is very critical and essential to ensuring that healing can be performed. As a result of this relationship, certain guidelines have been put into place to regulate doctor's performance and behavior.

Peer review processes have developed significantly over the past thirty years that has put into place a template of regulation that helps prevent poor performance and ensure that physicians are offering their best efforts towards their patients. There are indeed problems with this process that may in fact exacerbate the health problems of the patient and ironically let bad doctors continue on with their poor practices. The purpose of this essay is to discuss the weaknesses of the peer review process within the medical industry and how confidentiality within this process is detrimental to the entire outlook as well.

Current Problems

The well intended idea of keeping doctors on their toes and ensuring that they do not fall into bad habits is the main purpose of the peer review process within the medical industry. To accomplish such reviews the doctors have been guaranteed a certain amount of protection by having the contents of these review not available for punishment or legal action. This protection is based on the idea that when doctor's discuss their colleague's performance the issues discussed cannot be used against the doctor in question.

According to Gallegos (2012) "the AMA's policy position is that proceedings, records, findings and recommendations of a peer review organization are not subject to discovery. In medical liability actions, the privilege protects reviews of the defendant physician's specific treatment of the plaintiff and extends to reviews of treatment the physician has provided to patients other than the plaintiff, the policy says." This special treatment of these professionals that is offered by nearly 90% of the states in this country is not beneficial for doctor nor the patient in many cases, since secrecy provides a blanket of protection that has little to no punishment mechanism for those physicians who are derelict in their duties and should not be practicing medicine.

Many of the peer reviews are bogus insufficient displays of well intended, yet ethically empty, demonstrations that serve to distort and confuse rather than bring the truth to light. Those doctors who are intent on the peer review process having a regulatory effect are considered dishonorable whistleblower that have "ratted out" their peers in an effort to make themselves look better.

This approach has real problems where patients health are suffering and unnecessarily dying prematurely. Huntoon (2011) revealed that "Although thousands of patients die every year from preventable errors which occur in hospitals, many physicians today are afraid to come forward to report problems in hospitals out of fear that their careers will be ended by a retaliatory sham peer review. Fewer and fewer physicians are willing to risk their career and livelihood to protect patients in hospitals. It is easier and far safer for physicians to simply look the other way and remain silent. "

The Need for Protection

In such a system in which the professionals themselves need some sort of public protection from their actions suggests that the problem is widespread and the causes of this idea are most likely to blame. It becomes very obvious to understand this problem when understanding how and why this group needs protection. Protection is necessary for the weak, and it is important to come to grips with the idea, that despite all the education and training doctors receive, they are still extremely vulnerable for their actions.

The professionals in this area are rational to desire this protection as the threat of malpractice suits and other legal actions are extremely likely in this day and age where law suits are common place for seemingly no good reason. The interaction of the medical and the legal system are also important to realize to synthesize this problem in a whole and rational manner. When understanding the self-interest of the parties involved, the need for this type of protection that results out of confidentiality makes more sense, however does not offer any real solutions at first glance.

Why Doctors Don't Like Peer Review

There are several reasons why doctor's themselves, despite the protections they are offered, do not appreciate peer reviews and their problems that are associated with them. While confidential information may keep the lawyers away, the main threat to a doctor's professional development man indeed come from the peer review committee itself. Human nature dominates how we make our decisions and significantly affect our behavior, within the peer review setting, a useful opportunity is presented to those doctors, with little ethical substance, may take advantage of their peers and use this information in other ways. The process itself is not really about learning, but rather about assigning blame. This approach immediately puts people on the defensive, and it should be expected that distorted information and false signals will be displayed to help in that protection effort.

The demands of the public, now thanks to technology and the ability to rapidly communicate with almost anyone has also pushed doctors away from accepting the true benefits of peer review committees. Confidentiality cannot really be guaranteed in any form, in any way in today's society without great effort. There is a camera everywhere and many if not all of a doctor's professional actions are recorded somewhere in some form.

Lamki (2009) explained how, as doctors, the responsibility to the public and the responsibility to themselves often clash and that the peer review process, could have positive meaning if they information was not held as confidential. He wrote "The public is now connected to the internet where general education and knowledge are freely available. The public is now connected to the internet where general education and knowledge are freely available. The public also notes that industry, especially larger organizations such as oil companies, now insists upon peer review among employees. Some boards of education and high-quality private education organizations have recently instigated peer review among their staff. Why don't medical schools and medical organizations and institutions follow suit? Law makers, prosecutors and defense lawyers are all aware of the various laws passed in several countries such as the "Health Care Quality Improvement Act of 1986." 9 Thus lawyers have become more demanding and so has the public. The demands will likely become unreasonable and society that had previously granted us its trust may suddenly become alienated from us. "