It is unethical for a physician to disparage the professional competence, knowledge, qualifications, or services of another physician to a patient or a third party or to state or imply that a patient has been poorly managed or mistreated by a colleague without substantial evidence, especially when such behavior is used to recruit patients. Of equal importance, a physician is ethically obligated to report fraud, professional misconduct, incompetence, or abandonment of patients by another physician. Professional peer review is critical in assuring fair assessment of physician performance for the benefit of patients. The trust that patients and the public invest in physicians requires disclosure to the appropriate authorities and to patients at risk for immediate harm.
All physicians have a duty to participate in peer review.
Fears of retaliation, ostracism by colleagues, loss of referrals, or inconvenience are not adequate reasons for refusing to participate in peer review. Society looks to physicians to establish professional standards of practice, and this obligation can be met only when all physicians participate in the process. Federal law in most states provide legal protection for physicians who participate in peer review in good faith. Conversely, in the absence of substantial evidence of professional misconduct, negligence, or incompetence, it is unethical to use the peer review process to exclude another physician from practice, to restrict clinical privileges, or to otherwise harm the physician's practice. All health professionals share a commitment to work together to serve the patient's interests.