Sham Peer Review

06/08/2025

02/28/2025

09/02/2023

www.peerReviewJustice.org Sham Peer Review
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06/28/2023

From The Center for Peer Review Justice
www.PeerReviewJustice.org

Senator Milkovich on Hearing on SB 187: Licensees' Bill of Rights. By Senator John Milkovich.

Senator Milkovich: "Over the last decade, Licensing Boards have leveled false accusations against professionals, extorted exorbitant fines, rigged administrative proceedings, misused Board proceedings to destroy competitors, and engaged in patent conflicts of interest.

Senate Bill 187, by State Senator John Milkovich, seeks to ensure Due Process for Louisiana's professional licensees in licensure and disciplinary proceedings–– and seeks to curb abuses by Licensing Boards. Senate Bill 187 will be heard by the Senate Commerce Committee on Wednesday, May 1st, at 9:30 a.m. in the State Capitol. Licencees are encouraged to attend and make their voices heard. Persons who wish to testify, or have questions, should call 318-425-1957.

Senator Milkovich: "Licensing Boards in Louisiana have perpetrated a series of abuses against professional licensees: the fabrication of complaints and evidence; the exploitation of Board powers by Board Members to destroy professional competitors; coercing physicians who use neither drugs nor alcohol into drug rehab; the refusal to disclose to licensees copies of their case files; anonymous complaints; the denial of an explanation to licensees of the charges against them; a racket in which a disciplinary officer files false charges against professionals and then refers the professionals to her boyfriend, a lawyer, who collects a large fee; shakedowns for large fees that professionals are forced to pay, in order to practice their profession; rigged proceedings; and the Board's practice of functioning as judge, jury and prosecutor.

Notes Senator Milkovich, "Professionals, small business owners, and technical specialists spend their entire careers learning their skills and mastering their professions. Louisiana Physicians, who are among the groups targeted by abusive Boards, are among the most thoroughly educated, highly skilled and selfless professionals in the world–– and are some of the best physicians in America. Our doctors work long hours, fight with the HMOs and ERISSA plans to get paid, and grapple with endless red tape imposed by state and federal agencies. We owe them gratitude-- not grief.”

Continues Milkovich, "Doctors, Dentists and all other licensed professionals in Louisiana are entitled to just and transparent proceedings. None of them deserve to have their careers destroyed by corrupt practices or rigged proceedings. We understand that there must be a sound disciplinary process to protect the public. However, the goal of Board proceedings for licensees should be impartiality, fairness and integrity-- not intimidation, falsification, and inequity."

Senator Milkovich said, Under SB 187, professional licensees would be entitled to a clear statement of the charges against them; the identity of the accuser; a fair investigation; an independent judge; the prohibition of secret communications between the Investigator and the Board; receipt of their complete file; a fair hearing; full discovery; legal counsel; and meaningful judicial review.

Concludes Milkovich, "Licensing Boards exercise governmental power over professionals. However, there are few checks and balances on their power. Some Boards are out of control, run rough-shod over professionals, and abuse their power. It is time to require that Boards respect the Rule of Law; obey the Constitution; and treat licensees fairly.
--
John Milkovich
Louisiana Senate
656 Jordan Street
Shreveport, LA 71101
(318) 425-1957
johnmilkovichforsenate@gmail.com

06/15/2023

DOES THE GOVERNMENT KNOW WHAT IT IS DOING TO PHYSICIANS?
Don R. Read, MD, Past President TMA

Physicians spend almost twice as much time each day typing on computers and filling out paperwork as they do seeing patients. That astonishing conclusion comes from research published this week in the Annals of Internal Medicine.

Just think about that. How would you feel if you spent two hours documenting every hour of work that you do? How would your boss feel about it? You’d be depressed and frustrated; your boss would probably be angry as hell.

Patients should be up in arms over this report. Taxpayers should be up in arms. Physicians already are up in arms because we already knew this was true — and we know it’s just going to get worse.

We know it’s going to get worse because we know what’s causing it in the first place.

And that’s what’s missing in this study. Why? Why do physicians spend just 27 percent of their time “on direct clinical face time with patients” and 49.2 percent on electronic health records (EHRs) and “desk work”? From my nearly 50 years in medicine and thousands of conversations I’ve had with my colleagues, I can guarantee you it’s not a willing choice.

But again, the question is “why.” Why is this happening? Part of it has to do with EHR systems that appear to have been designed by someone who never set foot in a physician’s exam room. They’re clunky, not intuitive, and don’t fit the flow of how we examine, diagnose, and interact with our patients.

But the bigger issue is why we have to enter all of this data into a computer system in the first place. It comes back to an alphabet soup of government regulations that definitely were written by someone who’s never been in the exam room with a patient. The Physician Quality Reporting System (PQRS), Meaningful Use (MU), and the Value-Based Payment Modifier (VBM) program all aim to “capture” the quality of care we’re providing and score us on the cost of that care. MU — the worst-named government program ever — actually cuts our Medicare payments if we don’t use an EHR.

A study published in Health Affairs earlier this year estimates the cost in physician time to comply with just one of those programs, PQRS, exceeds $50,000 per primary care physician per year. That’s a lot of money; but it’s also a lot of our time. That’s time the government has stolen from our patients.

And — as I mentioned earlier — it’s only going to get worse. The Merit-Based Incentive Payment System (MIPS), part of the Medicare Access and CHIP Reauthorization Act (MACRA), begins in January. MIPS is supposed to replace PQRS, MU, and VBM. But, as I wrote in this space in June, the new program looks to be far more costly, complex, and confusing than the costly, complex, and confusing programs it is replacing.

The Centers for Medicare & Medicaid Services (CMS) estimates MACRA will add $128 million a year in compliance costs above the costs of complying with the programs it is replacing. Texas Medical Association analysis finds that “official” number woefully low.

And all of that brings us to one more, even bigger question: Does the government know what it’s doing to physicians?

We went to medical school and dedicated our lives to helping people heal and stay healthy, not to become data entry operators. But that’s what we have become, and that’s taking a toll on physicians, our patients, and the entire health care system. Physicians are burned out and unhappy, patients have less time with their doctors, and everyone has to pay more to get less care.

I’ve been a patient — a seriously ill patient — and I owe my life to the physicians who helped me recover from West Nile virus encephalitis. Like every patient, I don’t want a burned-out, unhappy doctor who’s enslaved by his computer. I want a bright-eyed, engaged, and satisfied physician who has the time and energy to put me — and my health — first.

More articles at The Center for Peer Review Justice
www.PeerReviewJustice.org
Legal@peerReview.org
The Sham Peer Review Hotline: 504-621-1670

Center For Peer Review Justice Richard B. WillnerMore Center for Peer Review Justice Testimonials.Richard Willner InterviewsListen to Interviews by Richard Willner.Articles by Dr. Richard B WillnerRead the latest articles and information from Richard Willner.Contact Richard WillnerEmail and telephon...

05/28/2023

HOW TO DESTROY YOUR COMPETITOR
(OR SOMEONE YOU DO NOT LIKE)
WITH MEDICAL PEER REVIEW

Bring the peer review action in the following ways:

1. Cut the physician's support staff. This generates inefficiency and disharmony in the remaining staff. It also lays the basis for the following.

2. Place a 'mole' in the office staff to collect a list of alleged wrongdoing, including the most trivial rumors and innuendoes. It is not the validity of these allegations, but the volume of the list, which matters. The target physician will be unable to address all the items if it is long, and the community will be more likely to believe it. It is preferable to use an outsider, newly hired, as the mole. Once the target physician is gone, fire the mole.

3. Include the Chief of Staff and two other adversarial physicians in the scheme. They can actually be kept ignorant of the true motives behind the attack. All physicians are busy and might accept data from authoritative figures, without carefully confirming their validity. Tell these doctors, for example, that the target has serious problems, which cannot be revealed without "hurting" him or her, implying personal failings, which must be kept confidential.

Hospitals which have this process well greased will usually have the same doctors "elected " to key positions year after year. They will maintain a clique of insiders who can be relied on to be supportive.

4. Begin a rumor campaign. Leak allegations to the entire medical staff and community at large. This can be done very cryptically. Any secretary who must type up corporate documents may unwittingly serve the purpose.

5. Restrict the physician's access to records. This will hamper efficiency and prevent proof of competency.

6. Use the most severe punishment (especially summary suspension) at the very outset of the review process. This will emotionally damage the target physician and his/her family, creating a shock effect. It also promotes the community's doubts about the physician's competence and character. This trauma may be all it takes to scare the physician out of town. A hasty departure only further damages the target's credibility, so that he/she will be presumed guilty. The immunity provided by the 1986 law prevents any scrutiny of the decision.

7. Limit the target physician's access to allegations, and keep them as vague as possible. The broader and more nebulous the charge, the harder it is to address it. Make the list as long as possible, even adding half-truths, frivolous allegations, rumors, and outright lies. The target will hardly have time even to read the list, and might succumb without a fight. The sheer length and vagueness of the list assures failure of the target to refute all the charges.

One added advantage to a massive list is that any physician asked to review the cases will also be overwhelmed and be more likely to accept the hospital's version of the cases.

8. Prevent the target from obtaining privileges at other institutions. Then, spread rumors dto the staff about the rejections by other institutions. This maneuver also keeps the target broken financially, unable to sustain legal aid.

9. Set up hearings so that only a few key insiders know what is happening. By this point, the whole hospital staff may have ostracized the target physician, if the rumors are sufficiently scandalous.

10. To help implement the plan, hire an aggressive law firm that favors corporate interests. Hospitals that routinely practice these schemes seem to use the same law firm.

11. Break the physician financially. Keep the list of allegations and the list of witnesses as long as possible. This will prolong the legal nightmare for the target, producing massive legal fees. The hospital can easily outlast the targeted physician in a protracted legal battle.
Clearly such dealings are not isolated incidents. It may well be that this systematic attack on individual physicians is being formulated by law firms that cater to aggressive hospitals, particularly those hospitals with monopolistic aims. The hospital's success in such attacks is almost guaranteed by the new federal law. Even when the hospital committee flagrantly denies due process to the physician, there is no longer a mechanism for exposing such practices. The 1986 law provides a degree of immunity that effectively veils their proceedings. Our best initial recourse is public awareness. If you have had a similar experience, or any insights into hospital-privilege battles, THE CENTER FOR PEER REVIEW JUSTICE, http://www.PeerReviewJustice.org would like to hear from you.

05/05/2023

SHAM PEER REVIEW

Description of disease:

The scientific method generally involves collecting data, making observations, developing theories on the basis of those observations, performing tests of those theories under controlled circumstances, and finally, taking a course of action if those tests prove the theories. Sham peer review is a backward malignant bastardization of the scientific method. It involves making a decision to take the action, then asking minions to collect the data to support the arbitrary decision. It happens in the corporate world every day, i.e., an executive wants to fire an employee, so he asks his lackeys to "get the documentation". This is exactly what happens to physicians in sham peer review as well.

Peer review is a healthy, scientific, positive process by which physicians review what their peers are doing, looking at variances, and studying the how simple outcomes of these variances, and then making recommendations based on these studies. If Dr. X does things differently from Dr. Y and Dr. Z, let's look at Dr. X's outcomes, and if they are not as good as Dr. Y's or Dr. Z's outcomes, perhaps Dr. X might consider changing his methods in order to improve patient care. The course of action usually involves additional education, and punitive actions really have no role in this type of process.

Sham peer review however is not at all concerned with improving patient care, it is usually motivated by corporate profits, greed, or sometimes merely as a personal vendetta if there has been a long-standing or intense animosity towards the physician. It is intended to get a physician "out of the way", perhaps kicked off of a medical staff, or even imprisoned, because he stands in the way of corporate profits even, or especially, if he is a whistleblower on the corporation's illegal or dangerous actions, although the physician may be acting out of a genuine concern for patient safety and care.

Prevalence:

Sham peer review is routinely used by hospital corporations and is currently at epidemic proportions. We know of many outstanding, good, ethical physicians who are currently no longer practicing his profession and support their families. Corporations use lawyers, the physician's personal enemies and economic competitors, and even legislators and law enforcement officials to help them in this bastardization of the peer review process. Sham peer reviewers are often successful if their financial resources dwarf the monetary resources of the physician they are trying to destroy. One of the main difficulties which the sham peer reviewer faces is keeping his true motives hidden, so the corporations which have slick public relations departments and are skilled at press releases, are often the most effective.

Diagnosis:

A good general rule is, any charges against a physicians methods which are not the result of medical staff committees staffed by physicians acting in accordance with medical staff bylaws, is strong suspicion for "SHAM" peer review. Truth often has no meaning in the sham peer review campaign, only the amount of efficient "spin" which the sham peer reviewer can generate, much in the same way that a lawyer is not interested in the truth when he is defending a known murderer, or a prosecuting attorney is interested in the truth because he simply wants to win his case also. Evidence which interferes with winning cases, even if it is truth, is generally disregarded or hidden. It is very common that the physician targeted for Bad Faith Peer Review has no history of medical malpractice suits or complaints to the State Medical Board.

Treatment:

An effective treatment is to consult with the Center for Peer Review Justice. We invite your email at info@PeerReview.org or a call on the Sham Peer Review Hotline: 504-621-1670

10/14/2022

Do you think that your Peer Review was full of woo?

www.peerReviewJustice.org

Let's Think on this

08/12/2022

Has the National Practitioner Data Bank Fulfilled its “Promise” to America?

When Representative Ron Wyden (Dem OR), the chief sponsor of the NPDA created it in 1986, it had the specific purpose of not allowing medical miscreants from dancing around the US and getting licensed to do bad things in other jurisdictions. This was why it was formed; and for a few years, it remained so. However, even at the beginning, data was allowed to be entered on the basis of hearsay and unproven charges. Later on, it blossomed out to become the primary tool for various institutions, hospitals and employers to get rid of employees and member physicians they did not like.

Eventually, as it exists now, it is essentially a blacklist that has much in common with the blacklisting of various artists, writers, actors and musicians who were not allowed to work because of alleged connections with the Communist Party in the 1950s. Many younger people do not remember this tragic time. There was no proof necessary for such a connection. Then, as now it caused some suicides among those “on the list.”

Now, the NPDB is the “bludgeon of choice” for institutions, hospitals and employers to get control over their associates, get them fired and use that process as a device to mow-down adversaries without any necessary proof. We are writing this to you because you have no way to know if those who are listed in the NPDB can be reliable, honest and co-operative professionals and employees.

The Center for Peer Review Justice now has a process to answer that important question for you. We will do the work necessary to get only those professionals who qualify through our “Rehabilitation” program. Some who enter our program may not complete it or get honored by diplomat status. They will have to work hard for it. It contains a number of “earned” features we can list for you later.

Our “insurance program:” If you have any doubts, concerns, actions or complaints against any of those healthcare professionals who graduate our program, you can call us DIRECTLY and we will contact the professional and have “open discussions” with them that your own customer may not be able to engage. If we can no longer provide that justification, we will disclose it to them and you. As part of our mitigation project, our healthcare professionals sign a release which allows us to subtract our accreditation “for cause.” We retain that right. It goes along with their diplomat status.

The difference between us and the institution who informed on them, is that we rely on REAL data and proof, which is usually absent when a complaint is part and parcel of the hospital who fired them.

At the present time, we understand why you automatically reject any applicant listed on the NPDB. But this Draconian action cuts out a significant number of highly trained physicians and others who are really able to serve your Locums clients with distinction and reliability.
The missing factor you need for accepting our clients is a demonstration of our specially designed “Rehabilitation” Program. There is nothing like it anywhere. There is nobody like us anywhere.

copyright 2022: The Center for Peer Review Justice. Richard Willner

01/20/2019

The Health Care Quality Improvement Act ( HCQIA) Federalized Clinical Peer Review Actions

BY RICHARD B. WILLNER, Executive Director

The Center for Peer Review Justice

The Health Care Quality Improvement Act of 1986 ( HCQIA) federalized "clinical review actions" ( Peer Review) by a "reporting entity" ( corporation, enterprise) in 1986. Before that, there was simply no federal law describing a 'reporting entity", which is in every instance a corporation with its own agenda for using and manipulating medical care doing a "clinical review action subject to "section 11112(2).



So the use of corporate peer review is simply as logically accurate as saying "reporting entity peer review" or more accurately "corporate clinical review action" a precise description of a new species of governance superior to the natural rights of person called physicians with statutory "standards" which was birthed in 1986.



If a corporation wants a doctor off the hospital staff they should simply part ways amicably or not. This is actually the right answer. Like losing your job at McDonald's or as a Microsoft executive you then go to work at Burger King or Oracle because you have objective value outside of the corporation and the corporation has no ability to destroy that objective value through some kind of contest over patient ( customer) loyalty.



Surprising that no one gets this.



Good or bad faith peer review is really a non sequitur to precisely what the statute describes, and that is what the courts have said repeatedly. In fact, if we test every other term for peer review against the "statutory standards" of HCQIA section 11112(a) there is no argument that can pe*****te immunity except fraud and that would be on the basis of a court voiding a corporate clinical review action so infected as void on the basis of public policy.



But that argument would have to be made ultra-very clear to the court to survive. "Very clear" to the extent that a five year old would understand it. No statutory construction can legitimately be construed to authorize fraud. And if this one is what we need to notify every potential medical student because the AMA is not going to do it.



I tend to not argue for the other side. So I try not to use their terms but terms that favor my side.



"Sham peer review" does not accurately describe HCQIA.



A fairly accurate taxonomy is 1) corporate peer review or 2) non-corporate peer review with adjectives like "sham" or "manipulated" or "bad faith" attached to it.



Corporate Peer Review, that peer review formula described in HCQIA as described by HCQIA is a big tent and big bias non-objective enterprise heavily laden with the struggle to bring the corporation as the patient advocate and a lot of quality nonsense.



In fact, HCQIA really does not even require physicians at all to gain corporate immunity per the statute. The Medical Executive Committee, the MEC, an executive body, is the decision maker in most every case. And, pragmatically, in most committees, there is one leader who has even taken the time to read the charges. The rest of the committee are physically present and often preoccupied. MEC's are not directly mentioned in the statute which is worded to make everyone think doctors are doing it when it is really lawyers.



I fail to see how the physicians even matter in corporate or maybe "enterprise peer review" as it used over whole hospital systems and insurance companies.



Corporate medicine and corporate peer review are certainly not platform concepts on most people's radar they prefer to think of doctors which a Hippocratic oath and public heath. I have been using the term and find that it most people do not feel that it is as value laden as sham or fraud peer review but people understand that there is a presumption of corporate bias. As many know know, corporations are not generally imbued with altruistic qualities and are certainly not candid or objective when it comes to their bottom line.





At the end of the day all that matters when one is sitting their with your life on the line is what are your "rights". Everything else is "BS". And, the only right is procedural due process, which is a right to a Hearing before the same hospital which serves as the prosecutor.

01/20/2019

A resource for physicians and surgeons who have been subjected to sham peer review tactics who want to get back to work and avoid expensive legal battles. It is an organization for medical doctors (MD's),osteopathic doctors (DO), and health practitioners .

01/17/2019

The Center for Peer Review Justice. www.PeerReviewJustice.org

info@peerReview.org
504-621-1670

Center For Peer Review Justice Richard B. Willner More Center for Peer Review Justice Testimonials. Richard Willner Interviews Listen to Interviews by Richard Willner. Articles by Dr. Richard B Willner Read the latest articles and information from Richard Willner. Contact Richard Willner Email and t...