VA Health Care
Physician Peer Review Identifies Quality of Care Problems but Actions to Address Them Are Limited Gao ID: HEHS-95-121 July 7, 1995Peer review--physicians reviewing the work of other physicians--is crucial to ensuring that quality care is provided to patients. An essential element of peer review is management support for actions recommended by the peer review process. Without such support, peer review is meaningless because no actions is taken on the peer reviewers' recommendations. This report examines the relationship between problem identification and problems resolution in the Department of Veterans Affairs' (VA) physician peer review. GAO discusses (1) how the results of VA peer review are being used in reprivileging and disciplining doctors with performance problems; (2) what the impediments to effective peer review are; and (3) whether VA was taking steps to identify, follow up on, and report to state medical boards and the National Practitioner Data Bank on the actions of those physicians who are no performing in accordance with professional standards.
GAO found that: (1) actions taken by VA to address quality of care problems are often limited to undocumented discussions with the physicians involved; (2) there is generally no record of the extent to which quality of care problems are addressed or the actions taken to deal with the problems identified; (3) VA is developing practice guidelines and using peer review to help reduce heavy reliance on professional judgment in peer review; and (4) VA medical centers are not reporting many actions taken against physicians to the National Practitioner Data Bank because of their restrictive reporting procedures.
RecommendationsOur recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.
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