April 02, 2015
The California Medical Association’s Institute for Medical Quality (IMQ) now provides two types of peer review services for medical staffs, including a clinical review of individual cases as well as a comprehensive evaluation of a physician’s entire practice. These services are customized for each medical staff, group or clinic, with fees based on the scope of services provided. IMQ peer review services are most helpful when the medical staff’s peer review body, with the consent of the subject physician, has freely sought such services as an aid to its own peer review process, not to override or to supplant that process.
IMQ Clinical Case Review consultations are conducted by two physicians of the appropriate specialty who have no conflicts of interest, with a confidential report presented to the organization at the end of the review. The report offers an objective evaluation of the clinical practice of one or more physician members of a hospital medical staff or medical group through peer review of selected cases. This consultation is intended as a helpful adjunct to a medical staff’s quality assessment and improvement process. It is most appropriate when a medical staff has performed peer review, but requires assistance to determine if the quality of care meets current professional standards.
For a Comprehensive Peer Review consultation, two physicians of a relevant specialty who practice in another geographic area assess the quality of care and services provided by one or more physicians, who must consent in advance to the consultation. It is most appropriate when a medical staff has performed peer review, but requires a broad assessment of a physician’s practice. It also may be used when a physician raises concerns about the conclusions from medial staff’s peer review.
Generally, the consultation begins with an on-site review of medical records selected by the organization and by the IMQ consultants. It continues with interviews with the involved physician(s), appropriate medical staff or medical group leadership, and key employees of the organization. The consultants also assess relevant credentials documents and quality-related data, then create a confidential report documenting their findings.
For more information, visit the IMQ website on Peer Review Consultations.
For more information about external peer review see CMA On-Call document #5205, “External Peer Review.” CMA On-Call documents are available free to members at CMA's members-only website. Nonmembers can purchase On-Call documents for $2 per page.