Dr. Scalpel weighs in on a physician’s view of the new Joint Commission requirements for Ongoing and Focused Professional Practice Evaluation, a thorny issue in the world of medical staff administration:
Dear Dr. Scalpel:
In accordance with Joint Commission regulations, we are required to request an evaluation of your clinical performance. The Credentialling Committee now requires the completion of an evaluation form by a peer in your specialty who is not a member of your group practice.
Attached, you will find a letter and accompanying evaluation form which you should forward to a peer of your choice for completion. In order to proceed with the processing of your reappointment application, it is necessary that you ensure that the required evaluation form is forwarded to a peer and returned to us in a timely manner.
How did we let this happen?
Read the rest of Dr. Scalpel’s comments:
Joint Commission’s stated goal with these new requirements is to improve the objectivity and validity of the credentialing/privileging process. Historically most hospitals have relied heavily on peer references, often from peers with a financial interest in the outcome, when determining whether or not a physician should be granted initial or ongoing privileges.
In fifteen years of reading professional evaluations I doubt that I’ve read more than ten that said anything other than "recommended." In general, no one wants to be the cause of a colleague’s loss of clinical privileges, particularly not when the practitioner is part of the writer’s professional practice group.
My best advice to the medical profession, which understandably feels put out by these additional requirements, is get involved and help your organization’s administration and medical staff office develop the best possible tools for objective, valid review of professional practice.
In today’s world, good or bad, it’s all about data.