What is a Physician Peer Review Lawyer?

A physician peer review lawyer is a licensed attorney who specializes in representing physicians in peer review proceedings. This includes the informal fact-gathering process, negotiation, and hearings. Their practice also covers appellate or post-hearing challenges to adverse peer review decisions. These lawyers are experts in reviewing peer review provisions in by-laws, statutes, and court decisions. They must consider possible disciplines in peer review settings, which can include proctoring, privilege limitations, summary suspension, or termination.

What are the Qualifications for a Physician Peer Review Lawyer?

1. Expertise in Regulations & Law:

   • Legal Expertise: Knowledge of Joint Commission, CMS, Conditions of Participation, and State Laws that govern medical practice. Understanding the community standard of care and legal protections for physicians requires a detailed and specialized knowledge set.

   • Negotiation Skills: Adept at conflict resolution on short notice, especially in peer review and summary suspensions due to dangers to patients. Negotiations are often completed within days or weeks of peer review actions.

   • Evidentiary Hearing Experience: Ability to appear at hearings where the doctor and the peer review committee present evidence leading to a decision on whether discipline should be imposed.

   • Appeals Experience: Capability to challenge negative hearing results by filing writs or petitions in a court of competent jurisdiction.