Sham peer review epidemic: A doctor’s career destroyed

An excerpt from The Medical Matrix: One Physician’s Story Maneuvering the Minefields of Medicine.

It was a routine Monday morning in the middle of May 2011. I had custody of my boys that day, so I dropped them off at school and headed to work.

As soon as I got to work I received a phone call from the vice CEO of the hospital. Maria (name changed) was a short woman with a chronically bad perm. She had a penchant for wearing tight mini skirts and high heels, and she could be heard click-clacking around the hospital corridors, carrying a clipboard with her at all times like a school hall monitor. Maria had worked her way up the hospital system.

The hospital was in a town of around twenty-five thousand people about forty-five minutes outside of San Antonio, Texas. It was in a town where Germans settled long ago. Hunting was a common pastime with quite a few physicians who owned large deer leases. It was not uncommon to see pictures of children under ten in the local newspaper posing with a rifle and their kill. There was a church practically on every corner of town. Bob, the CEO, ran all of the business meetings and did the public relations. He was the face of the hospital in a south Texas good old boy town. Maria was the brains of the hospital administration and held a lot of power.

No one really wanted to get a call from Maria. As soon as I heard her voice, I wondered what was going on.

“There is an emergency meeting of the peer review committee tonight at 6 p.m. and you are required to attend,” she said abruptly.

“Why?” I asked. “Did something happen?”

“Well, Dr. Kelly filed a formal complaint with the executive committee about one of her patients under your care over the weekend.”

Dr. Kelly was the newest addition to the hospital. I had been the only female obstetrician, along with the two older obstetricians, for about eight years. Dr. Kelly was born and raised in this town and came back to practice. She was brand new, only about nine months out of residency, and the four of us shared night call. The previous weekend I was on call and remembered having very few deliveries. I just had patients being triaged for labor, but nothing complicated or noteworthy happened. Dr. Kelly and I had a relatively cordial relationship. She didn’t call me to discuss her patient, as is usually customary if there are questions or concerns about patient care.

The meeting was set for the next night at six. I entered the lobby of the newly renovated hospital, not knowing exactly what to expect. I was one of the first to enter the conference room. Around a long oval mahogany table were about ten or so chairs, and Maria and her assistant were placing binders in front of each chair. As I found a seat, I opened the binder and immediately recognized what was about to happen. My heart sank. The binder held notes from various meetings about nurse complaints and notes about my probationary status going back several years. The binder was very thorough with dates, tabs, graphs, and letters. Basically, any grievance was meticulously and neatly filed away, curiously beginning the year I opened my solo practice. The doctors and administrators slowly started to file into the conference room. The chief of staff, Dr. Simons, sat at the head of the table. Next to him was Dr. Brown, the head of the executive committee. Across from me was Dr. Frank, the head of the peer review committee. I had worked closely with all of these doctors and had socialized with them at hospital gatherings and parties.

Dr. Frank opened the meeting by saying that the committee was filing a “summary suspension” of my hospital privileges which is given to a doctor who is considered an “immediate threat to the health and safety of society”. This is filed when a doctor shows up to the hospital drunk or on drugs or otherwise incapacitated. The committee members are, by law, immune to lawsuits.

“I’m not a threat to society. I didn’t come to work incapacitated,” I said. “All I can tell you is that Dr. Kelly said you shouldn’t have discharged her patient with high blood pressure, and she is now admitted for severe preeclampsia,” said Dr. Frank. I told him that I didn’t agree with her assessment and that if she had any concerns, she should have just called me, and we could review the case in our OB department if needed. Dr. Simons raised his index finger and, as he shook it in my face, said, “Well, I can’t talk about it. We’ll be sending you a letter. As of this moment, you have to leave the hospital, and you can’t deliver any of your patients in labor at this hospital ever again. You need to refer all of your patients to the other doctors on staff.” (The nearest hospital was thirty minutes away.) “If you turn in your letter of resignation by Monday, we won’t report you to the National Practitioner Data Bank.” I was then escorted out to the nearest exit by a security guard. I wasn’t even allowed to get my coat and clogs from my locker.

I subsequently went through a process called sham peer review, which is a method unscrupulous hospital administrators and physicians use to discipline, then subsequently cancel a doctor’s hospital privileges, mortally wounding his or her ability to practice again.

Within a few short weeks, I was forced to close my practice. After nine years, my hard-earned good reputation was destroyed. I didn’t resign by Monday and appealed the suspension, but lost as the sham peer review process is a kangaroo court where the guilty verdict is predetermined.

This is now happening in epidemic numbers.

Aysun Alagoz is an associate chief medical officer at a large federally qualified health clinic in San Antonio, Texas, where she takes care of the underserved and low-income population of patients. She is the author of The Medical Matrix: One Physician’s Story Maneuvering the Minefields of Medicine and can be reached at The Medical Matrix, on Facebook, and on Instagram @aalagoz1. 

Additionally, she serves as an assistant clinical professor at Texas A&M University, teaching nurse practitioner students. In her spare time, she can be found in a cooking class, gardening, practicing yoga, or hanging out with her two dogs and cat.


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