Medical Peer Review and Hospital Privileges

Medical Peer Review & Hospital Privileges

As a medical professional, it’s possible that you may find yourself summoned to a medical peer review hearing, which could ultimately result in the loss of hospital privileges or worse, the loss of your medical license in some more extreme cases. For this reason, it’s essential that you trust your case to an experienced legal professional who can present an aggressive defense while ensuring that you maintain your rights to due process.

At The Law Offices of Jeffrey C. Grass, our legal team works with physicians, nurses and military personnel who are facing a hospital peer review process. We are experienced and knowledgeable concerning all aspects of the Fair Hearing Procedures of the Bylaws and we work aggressively to ensure that clients avail themselves of the rights afforded under this legislation.

We act quickly and aggressively when assisting clients who are facing a medical peer review, due to the possibility of losing your hospital privileges on a temporary or permanent basis.

Medical peer review for the hospital practitioner is a very specialized area of law and to compound matters, hospitals frequently hire large law firms that are adept at destroying a doctor’s professional reputation, resulting in a loss of their ability to practice medicine. The attorneys with the Law Offices of Jeffrey C. Grass have been defending clients like you since 1993, so we are well-positioned to help you maintain your medical licensing, hospital privileges and the good reputation that you have worked so hard to establish.

The experienced defense attorneys with the Law Offices of Jeffrey C. Grass also offer defense for healthcare professionals who are facing state or federal administrative hearings, including SOAH, HIPDB and NPDB proceedings.

If you are a medical professional who is facing a medical peer review process and are at risk of losing hospital privileges, we encourage you to contact the Law Offices of Jeffrey C. Grass to discuss the details of your case in a free, fully confidential case consultation. Call (469) 291-0940.

Common Concerns and Questions on Medical Peer Review Defense

The Law Offices of Jeffrey C. Grass maintains a national presence. We travel around the country, defending our clients’ clinical privileges and their professional reputations. Hospital practitioners who retain the services of our firm are assigned both experienced legal counsel and physicians and nurses on staff to prepare and defend their case. We have found that addressing both the legal complexities of the case along with the medical aspects of a complaint is a winning strategy.

Of course, as you proceed with your medical peer review case, you may have lots of different questions or concerns, so our legal team has addressed a few of the most typical questions in this regard.

What Happens If the Medical Peer Review is Initiated in Bad Faith?

Medical Peer Review and Hospital PrivilegesWhile some medical peer review proceedings are performed in response to a legitimate concern, a startling number of cases are initiated in bad faith. Often, this claim is made in an attempt to harm or retaliate against a physician or another medical professional. Unfortunately, the physician or nurse is faced with the task of defending against these allegations.

Some of the most common motivations for initiating medical peer review proceedings in bad faith include:

  • Economic – A doctor may be targeted for providing services that compete with the hospital or other doctors, or for declining to participate in economic ventures that benefit the hospital.
  • Retaliatory – A medical professional could be targeted as part of a retaliatory measure for raising concerns about the quality of care, the safety of patients, or the competence of other practitioners at the hospital.
  • Political and interpersonal – A physician may be targeted because he or she has differing political views or personal conflicts with administrators or other members of the hospital staff.

A “sham” medical peer review is often characterized by summary discipline with little to no basis in fact, accompanied by disruptive physician claims over psychological or personality issues. A hospital may instruct the physician to obtain a psychiatric evaluation, implying the physician is psychologically unstable or unwell. False claims of mental instability are most common in cases where there is no factual basis to support a claim of substandard medical care.

In these cases, it is especially important to hire an attorney who can defend your medical license, your hospital privileges and your reputation as a healthcare professional.

Can I Take Action if I’m Accused of Being Mentally Unstable in a Medical Peer Review or Other Proceedings?

If economic or political competitors who are also members of the hospital’s medical executive committee (MEC) or credentials committee complain the physician is disruptive and calls for a psychiatric evaluation, they can be accused of liable defamation.

This scenario is most common in hospitals that turn to the use of hospitalists instead of private specialists. These sham peer review actions are used to cull out private practitioners. This type of peer review is termed “economic credentialing.”

If you have received notification that your professional conduct is in question and you are being asked to undergo a psychiatric evaluation by a mental health provider selected by the hospital, you need immediate protection. This is a case where the Law Offices of Jeffrey C. Grass will actively work to protect your reputation and your career.

Our goal is to help competent medical professionals to avoid a situation where they are wrongfully deemed mentally unsound – a determination which can lead to reports with the NPDB and the state licensing boards, ultimately leading to the loss of your medical license and the loss of your career.

What is the Nurse Peer Review Process?

The Nurse Peer Review process is similar to the Medical Peer Review process that is used for physicians. In this proceeding, the hospital seeks to determine if a nurse has violated the Nurse Practice Act.

The committee will also evaluate the complaint to determine if the incident was minor in nature or one that warrants reporting to the Nursing Board. If a nurse is reported to the Nursing Board, he or she will typically be subject to a disciplinary process.

Nurses who work at hospitals employing over 15 nurses are entitled to a Nurse Peer Review Hearing in cases where there are allegations of a Nurse Practice Act violation.

We represent Licensed Vocational Nurses (LVN), Registered Nurses (RN) and Nurse Practitioners (NP).

The most frequent allegations comprising such violations are quality of care issues, drug violation or abuse, drug diversion, and HIPPA violations, to name a few. The guidelines for conducting such hearings are found in the Nurse Practice Act and the Board’s rules.

The hearing may result in termination, an HIPDB report, a report to other nurse clearinghouse databases, a report to the Healthcare Resources and Services Administration (HRSA) or a report to the NCSBN service for employers.

If you are a nursing professional who has received notification of an upcoming nursing peer review meeting, you should immediately contact one of our attorneys for legal advice and assistance.

Our Medical Defense Lawyers Assist Medical Professionals Facing Peer Review and Loss of Hospital Privileges

Medical Peer Review and Hospital PrivilegesAt the Law Offices of Jeffrey C. Grass, we know how frightening and stressful it can be to find yourself accused of wrong-doing, especially when that accusation could place your career in jeopardy.

Our law firm was founded by Attorney Jeffrey C. Grass, an established member of the Health Law Section of the Texas State Bar. In practice for over 20 years, Attorney Grass also served as a U.S. Navy Judge Advocate (JAG), in addition to achieving an AV® Preeminent Peer Review Rating from Martindale-Hubbell®.

Don’t face these serious accusations alone. If you are a nurse or physician who is facing a peer review hearing, contact the Law Offices of Jeffrey C. Grass as soon as possible to discuss your case in a confidential, no-cost case consultation session. Call (469) 291-0940.

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Life is struggle. Medical boards can be draconian - unfeeling, uncaring, unknowing, ensconced in ivory towers with their ideas of "the way things ought to be". Bureaucrats and technocrats in all those acronymic agencies or hospitals LIKE having power over our lives. Sometimes "stuff happens", somebody has a bad outcome, and their families feel the need to blame someone else. Clerks can make simple mistakes that have profound implications on our lives. Some people are just greedy, and vicious as well. Life may be struggle. Life may be difficult, especially for those of us who are actually out there in the trenches, doing our best to help others, not realizing that there are snakes and ditches out there just waiting for us to wander by, especially those of us who have no idea of what to do after we fall in one of those ditches or get bitten by the snakes. Jeff Grass DOES know what to do. He has helped me immeasurably with my struggles and difficulties. He has helped both my wife and me not just with our legal problems but with our fears and anxieties with good advice, good direction, and good actions. He is not just a Marine, he is more like a Marine sniper who knows just where to place his shots to work miracles. Not only that, he is available. And you get his attention when you need it, not when it's merely convenient. Got a problem with, well, just about anything? Why go anywhere else? Call Jeff Grass - he will "git 'er done".

- Robert W.

Plano, TX