going to settle, they kept filing motions that cost me $25,000 to answer. Their tactic was to deplete my financial re- sources, and that’s just what they did,” he said.
He says the road to settle the suit was “an uphill battle,” and it helped to have TMA in his corner. “It was comforting to know someone cared about what I was going through.” Mr. Hughes also appreciates TMA’s
support.
“I believe the trial court gave great weight to the TMA briefing on the is- sue of what is and what is not a medical peer review committee,” he said. The other seven physicians have not sued the hospital.
A fair review
TMA advocates a peer review system that improves patient care standards. TMA’s policies on medical peer review promote a fair, reasonable system; the association condemns peer review abus- es that harm physicians and have nega- tive ramifications for patient care. (See “TMA Supports Fair, Effective Peer Re- view,” at right.)
Doctors subjected to unwarranted
peer review action can sue. The Texas Medical Practice Act and the Health Care Quality Improvement Act of 1986 require health care entities, such as hos- pitals, medical societies, and HMOs, to follow certain standards and procedures when evaluating a physician’s delivery of care. The law gives physicians the right to due process, notice, and an op- portunity to request a hearing. It says a physician shall receive a copy of the committee’s final decision, including a statement of the basis for that decision if the peer review committee takes action that could result in suspension, restric- tion, limitation, revocation, or denial of membership or privileges at a health care facility. Dr. Mask’s lawsuit charged that Coon Memorial failed to meet its legal obli- gations to due process. Mr. Hughes ar- gued Mr. Schaffner’s letter and the ER/ Trauma Committee’s action affected Dr. Mask’s ability to practice at other insti- tutions. Dr. Mask says he never received notice or an opportunity to have a hear-
TMA supports fair, effective peer review
TMA’s policy on peer review denounces use of a review for non-patient care issues aimed at penalizing physicians for other business, financial, or administrative reasons. The policy says TMA will work to:
• Ensure accused physicians receive reasonable rights and due process for peer review and quality assessment efforts;
• Solicit member input and address issues on misuse of the peer review process or “disruptive physicians” policies by health care facilities or peer review entities;
• Educate and inform members about the potential misuse of peer review;
• End the use of “disruptive physicians” policies extended to non-patient care issues, such as economic credentialing, fail- ure to support marketing or business plans of the hospital or health care facility, or when physicians raise serious quality or patient safety issues about the facility and their practice;
• Strongly condemn sham peer review and manipulation of medical staff bylaws by hospitals attempting to silence physi- cian concerns for access to quality care at hospitals; and
• Aggressively oppose sham peer review, manipulation of medical staff bylaws and enforcement of such bylaws, and other tactics that chill or inhibit staff physicians’ ability to advocate for their patients.
December 2013 TEXAS MEDICINE 53
ing and alleges the hospital’s conduct constituted “sham peer review.”
Lessons learned Dr. Mask’s suit against Coon Memorial Hospital has broad implications for phy- sicians across Texas. “Doctors who leave hospitals should
always check with the medical staff coordinators and the credentialing and ethics committees to make sure there is no negative information in their files that could be transmitted on to subse-
quent hospitals. If there is, the physician should clear up whatever needs to be cleared up,” Mr. Hughes said. “A mis- take by one hospital where the doctor worked years ago can have really bad consequences.” Mr. Hughes offers some guidance for physicians to make sure their rights are protected during a peer review. “Peer review by individuals from the same discipline with essentially equal qualifications promotes better medical care and improves patient safety. I would
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