Peer review benefits everyone
Orlando, Fla.—“No dentist wants to find himself in a courtroom.”
Those nine words, spoken by Dr. Henrik Hansen, were part of the message from Peer Review and Dispute Resolution, the Oct. 11 continuing education course that centered on organizing and implementing peer review programs—the process the profession uses to resolve disagreements about dental treatment that dentists and patients can’t resolve themselves.
The annual session course, which Dr. Hansen co-facilitated with Dr. Stephen Simpson, also included a discussion of mediation and offered tips on resolving disputes. The annual session course, which Dr. Hansen co-facilitated with Dr. Stephen Simpson, also included a discussion of mediation and offered tips on resolving disputes.The annual session course, which Dr. Hansen co-facilitated with Dr. Stephen Simpson, also included a discussion of mediation and offered tips on resolving disputes.
|Resolving disputes: Dr. David Nielson asks a question during a course on peer review at annual session.
One of the ways dental societies conduct peer review is through mediation and evaluation. Almost all ADA constituents have peer review programs in place, as do most component societies. The committees consist of dentists who donate their time to evaluate questions about the appropriateness or quality of care and who recommend how to solve the problem. In some states, a lay person assists in the evaluation.
Consistency is one of the biggest issues.
“As dentists, we tend to be raving perfectionists,” Dr. Hansen said. “The thing to remember when you’re evaluating a colleague’s work is, does it meet the standard of care? It may not be perfect, it may not be the way you would do it, but does it meet the standard of care?”
Added Dr. Simpson, “the system is not set up to make broad statements on quality of care.”
Participants also learned which types of cases are not intended for peer review, including cases in litigation, cases that violate dental practice acts or ones that are suspected of fraud. Dentist-to-dentist complaints are also not covered by the process.
Dr. David Nielson, a general dentist from Anchorage, Alaska, who chairs his state’s peer review committee, said the course taught him how cases are sent or not sent to the National Practitioner Database and how to determine under what circumstances dentists are required to report to the database.
“We have to re-evaluate how we reimburse patients who have successful claims in the peer review process,” Dr. Nielson said.
Although not every state utilizes mediation, those that do resolve more than half their cases through this alternative dispute resolution process. The bottom line difference between peer review and mediation is that the single goal of mediation is to bring the parties to a mutually agreed upon result. Decisions are not rendered in mediation; the parties themselves decide if they can resolve their differences.
Dr. Dave Preble, director of the ADA Council on Dental Benefit Programs, summed up the course, saying, “Everyone seemed to agree that whether through mediation or peer review, dentists are better served by resolving patient disputes through this dental society-sponsored program than through the court system.”