[Answered]: Hypothetical: Dr

Hypothetical: Dr. Anderson was working for the Blackacre Medical Group when she decided to start her own practice. Dr. Dredd, incensed by this betrayal, sets out to crush her personally and professionally. As a member of the only local hospital’s peer review committee he brings Dr. Anderson up on accusations of having given substandard care. He schedules the meeting for the committee for the very same night that Dr. Anderson announces she is leaving his group. At the meeting Dr. Dredd brings a handful of Dr. Anderson’s files. He does not even bother to open or present them to the committee before forcing them to a vote to remove Dr. Anderson’s hospital privileges. The other doctors, fearing Dr. Dredd’s retaliation if they question his behavior, do not intervene to get the facts. The vote is 6-0 in favor of rescinding Dr. Anderson’s privileges. Based on what you know about the Health Care Quality Improvement Act and the Poliner v. Texas Health System case, is Dr. Anderson likely to be able to sue for damages? No. The peer review process qualifies as a “professional review action” under the HCQIA, which is completely protected from liability. No. The HCQIA bars actions against even bad faith or fraudulent actions so long as they are taken through the peer review process. Yes. The HCQIA limits a plaintiff’s ability to bring an action for negative peer reviews, but Dr. Dredd and the committee have exceeded the scope of the law by failing to make reasonable efforts to obtain facts, give adequate notice of hearings, or to show that their actions were warranted by the facts known. Yes. The HCQIA does not limit a plaintiff’s ability to bring an action against a defenant who has an ulterior motive besides the quality of care.