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Peer review under fire: Real problems or trumped-up accusations?

Fueling the debate is a rising concern that the confidential system is too easily abused.

By Tanya Albert and Damon Adams, amednews staff. Oct. 10, 2005.

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Terrence Babb, MD, said his troubles started when he complained about the quality of care provided at the clinic where he worked.

The then-Pennsylvania obstetrician-gynecologist raised questions about some physicians and how they provided care, including the case of a woman who died following delivery, court records show. Not long after voicing concerns about what he saw at Penn State Geisinger Clinic and Centre Community Hospital, he was fired. Dr. Babb said it was in retaliation.

He believed he was unfairly scrutinized for bringing attention to quality issues and sought relief through the hospital's peer review.

"All I was doing was trying to take up for the patients," he said.

Geisinger officials would not comment on the case. But in court documents, officials said it had not targeted Dr. Babb.

A civil court jury later found that doctors did not cause the death of the woman Dr. Babb raised concerns about. But the jury found one of the doctors negligent in the woman's care.

For more than eight years, Dr. Babb has waged a legal battle over his own case. This year, he hopes a jury will finally decide whether he was wrongly singled out for "disruptive behavior" by complaining about quality of care.

"The perversion of peer review is more widespread than doctors think," said Dr. Babb, who is now a locum tenens physician at Keller Army Community Hospital in West Point, N.Y.

Many physicians say the vast majority of peer review in the hospital setting is done properly, but Dr. Babb is among a growing number of physicians who are raising concerns that the confidential system is too easily abused. Their complaints are gaining traction in the courts, and more medical societies are discussing the issue.