Clark Stanton, a peer review lawyer and partner with Davis Wright Tremaine LLP in San Francisco, said the 5th Circuit also affirmed the importance of analyzing the peer review process as a whole, "without pulling it apart into bits and pieces, as has been done at the trial court level."
While damage immunities appear to weigh in favor of peer reviewers, doctors who feel they have been wronged are not without remedy, Stanton
warned that review committees risk losing immunity under state laws for eschewing staff bylaws.
He pointed to a June Minnesota Appeals Court ruling in which a physician under review won injunctive relief after judges found that a hospital's failure to follow the staff bylaws amounted to malice under the state's peer review law.
In addition to following HCQIA-outlined procedures and staff bylaws, Stanton
recommended that peer review committees tailor their actions to the perceived health care problem at hand rather than rely on a summary suspension -- another key the 5th Circuit emphasized in determining if a review panel acted reasonably.
In the face of such disclosures, "the fight and the goal of the [peer review committee] is to try to limit what's turned over to only the necessary and relevant information," Stanton
said state and federal laws "reflect the judgment of all 50 legislatures that immunity and confidentiality are important elements of peer review."