In a court case that is deeply concerning to physicians and hospitals, an Ohio appellate court ruled that the state’s peer-review privilege law didn’t protect a resident physician’s file from discovery in a civil lawsuit.
It appears to be the first time an Ohio court has addressed whether Ohio’s peer-review statute (R.C. 2305.252) applies to residency files that a peer-review committee has generated for quality assurance purposes.
Hospitals say the state appellate court’s decision is a bad one for a system set up to give physicians and other health professionals the assurance they need to talk freely to improve care without the fear of what they say being discoverable in court.
The Litigation Center of the American Medical Association and State Medical Societies, the Ohio State Medical Association (OSMA), the Ohio Hospital Association and Ohio Osteopathic Association filed an amicus brief urging the state’s highest court to overturn the appellate-court ruling.
“Given their evolving knowledge and clinical experience, resident physicians need the same assurance as fully licensed physicians—if not more—that confidential information generated during peer review for performance and quality improvement purposes will not be used against them in a future civil action,” says the amicus brief that the AMA Litigation Center, OSMA and others filed in the case, Stull et al. v. Summa Health Systems et al.
The brief tells the court that nothing in the statute makes a distinction between resident physicians and fully licensed physicians and it notes that “for good reason, this court has never made that distinction either.”
“The Ninth District’s decision … significantly undermines the purpose of the peer review process within a hospital,” the brief says. “If the Ninth District’s ruling is not reversed and clarification is not provided to Ohio’s lower courts, Stull will cause irreparable damage to the trust in the peer review process and the willingness to engage in candid conversations to reduce morbidity and mortality among patients and improve the overall quality of health care services.”
Residency review is peer review
Kalvyn Stull received care at Summa after he was injured in an automobile crash. Stull claims the treatment he got made his brain injuries more severe and he sued Summa for medical negligence.
During the discovery process, he asked for the resident file of one of Summa’s resident physicians. Summa refused the request, citing peer-review privilege. Stull challenged that and the trial court agreed with him, saying Summa didn’t meet its burden to show peer-review privilege protected it.
The appellate court upheld that lower-court decision and Summa is now asking the Ohio Supreme Court to weigh in.
The brief the AMA Litigation Center, OSMA and others filed tells the state supreme court that the appellate court “misconstrued the peer review process for resident physicians and created an unwarranted distinction between ‘peer review’ and ‘residency review.’”
The brief explains that the appellate court got it right when it concluded that Summa designated committees to specifically review and evaluate its resident physicians’ competency, professional conduct and quality of care. Summa’s Graduate Medical Education Committee and its Clinical Competency Committees for each residency program fall within the Ohio law’s definition of a “peer review committee,” physicians and hospitals say.
However, they say, the appellate court got it wrong when it concluded that peer review privileges didn’t cover residency files, noting that a “distinction between ‘residency review’ and ‘peer review’ are unwarranted.”
The brief explains that because residents have a limited scope of practices, they have a different credentialing and evaluation process than fully-licensed physicians and Summa—like other institutions —has set up a separate peer-review committee for residents.
“The use of the broad term ‘health care providers’ in the statutory language cannot—and should not—be interpreted to exclude resident physicians from the protection of peer review privilege,” the brief says, underscoring to the court that the case “will impact the practice of medicine, the post-graduate training of resident physicians, and the overall quality of health care services delivered to the general public in Ohio.”