Resolution on collegial relations Submitted by the Pima County Medical Society, June 2006 – referred to Arizona Medical Association Legal Reform Task Force
WHEREAS: in the interest of good patient care, amicable relations between physicians are necessary; and
WHEREAS: physicians’ performance is hindered in an atmosphere of secretiveness and suspicion; and
WHEREAS: physicians are at an enormous disadvantage in a hospital administrative proceeding; and
WHEREAS: the simple instigation of an administrative investigation or threat of an adverse action is highly disruptive and financially devastating to a physician, and in itself precludes amicable problem solving because of legal reporting requirements; and
WHEREAS: observance of procedural due process guarantees neither substantive due process nor fundamental fairness; and
WHEREAS: peer review is done in isolation, so that the targeted physician can be held to a much higher standard than others in the same department; and
WHEREAS: there are many uncertainties in the art and science of medicine, as well as sharp differences of opinion even among experts, and
WHEREAS: when patient safety is truly in jeopardy, making the practitioner aware of the problem immediately is far better for patients than delays to accumulate evidence to build a case against him; and
WHEREAS: the outlier or dissenter is not necessarily wrong, nor the consensus necessarily right; and
WHEREAS: the integrity of the medical profession requires that patient care problems should ordinarily be resolved by medical professionals with untainted motives, rather than by lawyers or hospital administrators;
BE IT THEREFORE RESOLVED THAT: ArMA develop and encourage the use of peer review with the following characteristics and also work for legislation that would prohibit discovery or admissibility of mediation proceedings by plaintiff’s attorneys in malpractice lawsuits:
(1) Any concerns about a physician’s performance should first be discussed in a collegial, nonthreatening manner with the involved physician, by one or more members of the medical staff.
(2) The physician be made aware of all concerns with ample notice and with full access to documents needed to prepare a defense.
(3) Standards by which a physician is judged shall be openly announced and applied to all equally.
(4) A mediation procedure by an unbiased body, such as a committee of the county medical society, should be the next step if medical staff officers or colleagues are not satisfied with a practitioner’s response.
(5) The goal of mediation should be to facilitate a mutually agreeable outcome that protects both patients and physicians.
(6) Official procedures with potentially punitive outcomes should be undertaken only if mediation fails.