How does a medical staff define its cultural values for peer review? The first requirement is for physician leadership to have a vision of better values. Unless physician leaders can articulate to the staff what they would like the culture to become and why, most people are not interested in change for change’s sake. Typically, development of these values begins with the leader’s recognition that peer review is perceived to be, or actually is, punitive. Then, through outside education, the physician leadership realizes that there is a better way.

In 2019, primary care physicians earned an average of $237,000 and specialists earned $341,000. This is according to the 2019 Medscape Physician Compensation Report, which surveyed almost 20,000 respondents in 30 specialties. Orthopedics was highest earning specialty at $482,000. According to Medscape, orthopedics has been in the top five earning specialties every year for the past five years.

A “no-retaliation” policy makes it clear that reporting improper conduct is a duty of all staff members. It articulates the disciplinary consequences of any effort to punish an employee for carrying out this duty. Hospital leadership must enforce the policy vigorously; otherwise, their assurances to staff members about reporting will lack credibility. Retaliation is just as serious—if not more so—than the original offense. It creates a hostile work environment. Consider the following language from The Medical Staff Leader's Practical Guide for your organization’s no-retaliation policy.

Collegial intervention is an administrative attempt to resolve issues informally, rather than go down the road of formal corrective action, which is difficult for all involved, says Sarah Coyne, partner at Quarles & Brady LLP.

We invited participants to submit, in advance, a brief case study describing their own challenges. We then advised them in greater depth regarding potential solutions. The participants could also interact in real time to ask additional questions or to clarify their concerns. The hope was that audience members who did not submit their own case study would benefit from the discussion of challenges facing the other organizations and from the broader overview.

One-fourth of America’s practicing physicians are age 65 or older, and this proportion will continue to rise as the peak of the baby boomer generation enters the ranks of the elderly. According to the AMA, more than 40% of the nation’s 1 million doctors are older than 50. These are daunting statistics. Significant numbers of doctors practice into their 70s and beyond with competence and care.