Clinical Peer Review: Burnishing a Tarnished Icon
Authors: Peter E. Dans
Journal: Annals of Internal Medicine (1993)

Editorials1 April 1993Clinical Peer Review: Burnishing a Tarnished IconPeter E. Dans, MD, Deputy EditorPeter E. Dans, MD, Deputy EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-7-199304010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Hayward and colleagues, in this issue of Annals, show that implicit criteria, widely used in peer review to assess quality of care, are inadequate. Prescriptions for improving peer review are suggested.Physician groups frequently extol the sanctity of clinical peer review. In this issue of Annals, however, Hayward and colleagues [1] confirm that the way most physicians and review organizations do peer review to assess quality of care is unreliable [2]. Well-trained internists were asked to judge the appropriateness and quality of care on a general medical ward. Raters were taught a structured, implicit criterion approach, in which their perception ...References1. Hayward RA, McMahon LF, Bernard AM. Evaluating the care of general medicine inpatients: how good is implicit review? Ann Intern Med. 1993; 118:551-7. Google Scholar2. Rubin HR, Rogers WH, Kahn KL, Rubenstein LV, Brook RH. Watching the doctor-watchers: How well do peer review organization methods detect hospital care quality problems? JAMA. 1992; 287:2349-54. Google Scholar3. Rubenstein LV, Kahn KL, Reinisch EJ, Sherwood MJ, Rogers WH, Kamberg C, et al. Changes in quality of care for five diseases measured by implicit review, 1981 to 1986. JAMA. 1990; 264:1974-9. Google Scholar4. Dans PE, Weiner JP, Otter SE. Peer review organizations: promises and potential pitfalls. New Engl J Med. 1985; 313:1131-7. Google Scholar5. Kellie SE, Kelly JT. Medicare peer review organization preprocedure review criteria: an analysis of criteria for three procedures. JAMA. 1991; 265:1265-70. Google Scholar6. Department of Fiscal Services. Sunset review: state board of physician quality assurance: an evaluation report prepared pursuant to the Maryland Program Evaluation Act. Annapolis, Maryland; October 1991; 49. Google Scholar7. Codman EA. The product of a hospital. Surg Gynecol Obstet. 1914; 18:491-6. Google Scholar8. Reverby S. Stealing the golden eggs: Ernest Amory Codman and the science and management of medicine. In: Bulletin of the History of Medicine. 1981; 55:156-71. Google Scholar9. Donabedian A. Explorations in Quality Assessment and Monitoring. Vol. 1. The Definition of Quality and Approaches to Its Assessment. Ann Arbor, Michigan: Health Administration Press; 1980. Google Scholar10. Williamson JW. Improving Medical Practice and Care. Cambridge, Massachusetts: Ballinger; 1977. Google Scholar11. Sanazaro PJ, Williamson JW. A classification of physician performance in internal medicine. J Med Educ. 1968; 43:389-97. Google Scholar12. Brook RH, Avery AD, Greenfield S, et al. Quality of Medical Care Assessment Using Outcome Measures: An Overview of the Method (R-2021/1-HEW). Santa Monica, California, RAND Corporation; 1976. Google Scholar13. Holman HR. The excellence deception in medicine. Hospital Practice. 1976; 11:11, 18, 21. Google Scholar14. Deming WE. Quality, productivity, and competitive position. Cambridge, Massachusetts: Massachusetts Institute of Technology, Center for Advanced Engineering Study, 1982. Google Scholar15. Brook RH. Health services research: is it good for you and me? Acad Med. 1989; 64:124-30. Google Scholar16. Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978; 88:251-8. Google Scholar17. Dans PE, King TM. An office of medical practice evaluation: What is it and why have one? Quality Review Bulletin. 1986; 12:320-5. Google Scholar18. Mold JW, Stein HF. The cascade effect in the clinical care of patients. N Engl J Med. 1986; 314:512-4. Google Scholar19. Dans PE. Passengers and patients: some ruminations about quality of care. The Pharos of Alpha Omega Alpha. 1988; 51:2-7. Google Scholar20. Brook RH. Quality of care: do we care? Ann Intern Med. 1991; 115; 486-90. Google Scholar21. Kessner DM. Quality assessment and assurance: early signs of cognitive dissonance. N Engl J Med. 1978; 298:381-6. Google Scholar22. Audet AM, Greenfield S, Field M. Medical practice guidelines: current activities and future directions. Ann Intern Med. 1990; 113: 709-4. Google Scholar23. American College of Physicians. Universal insurance for American health care: a proposal of the American College of Physicians. Ann Intern Med. 1992; 117:511-9. Google Scholar24. Peterson OL, Andrews LP, Spain RS, Greenberg BG. Analytic study of North Carolina general practice, 1953-1954. J Med Educ. 1956; 31:1-165. Google Scholar25. Payne BC. The medical record as a basis for assessing physician competence. Ann Intern Med. 1979; 91:623-9. Google Scholar26. Chassin MR. Quality of care: time to act. JAMA. 1991; 266:3472-3. Google Scholar27. Tarlov AR, Ware JE, Greenfield S, Nelson EC, Perrin E, Zubkoff M. The medical outcomes study: an application of methods for monitoring the results of medical care. JAMA. 1989; 262:925-30. Google Scholar28. Chambers LW. Physical and emotional function of primary care patients: scientific requirements for the measurement of functional health status. JAMA. 1983; 249:3353-5. Google Scholar29. Delbanco TL. Enriching the doctor-patient relationship by inviting the patient's perspective. Ann Intern Med 1992; 116:414-8. Google Scholar30. Farrington JF, Felch WC, Hare RL. Quality assessment and quality assurance. N Engl J Med. 1980; 303:154-6. Google Scholar31. JuvenalSatires as Quoted By Ehrlich E. In: Amo, Amas Amat and More. New York: Harper and Row; 1985: 239. Google Scholar32. Berwick DM. Continuous improvement as an ideal in health care. N Engl J Med. 1989; 320:53-6. Google Scholar33. Laffel G, Berwick DM. Quality in health care. JAMA. 1992; 268: 407-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: Corresponding Author: Peter E. Dans, MD, American College of Physicians, Sixth Street at Race, Philadelphia, PA 19106. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEvaluating the Care of General Medicine Inpatients: How Good Is Implicit Review? Rodney A. Hayward , Laurence F. McMahon , and Annette M. 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