"We don't come down on them with a ton of bricks, but we send a peer review team to say, 'Here's a heads up," says James W. Pichert, PhD, co-director of the medical center's Center for Patient and Professional Advocacy, which runs the peer messenger program. "This is holding up a mirror to the physicians, and it shows that 'this is your data of what you are doing.' It's not a gotcha. We always appeal to their great sense of professionalism."
Physicians who are named peer messengers are nominated by hospital leadership, undergo training, and represent various disciplines within the hospital. They interview and help counsel docs who are targets of patient complaints that may range from how they communicated with to how they were billed.
Generally, these doctors have not committed violations of their practice. In severe cases, where violations are alleged, lawyers likely would be involved. Instead, the docs that the peer messengers see have practices that are falling "outside the norm of expectations, or the norm of best practices," Pichert says. For the most part, these doctors "are absolutely unaware that they stand out in that way," he adds.
VUMC is finding that the peer messenger review process is making significant inroads in helping physicians turn around their practices or behaviors, Pichert says. A dozen other community and academic medical centers also are using a similar peer review process, he adds.