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To the Editor: The article by Dr Baldwin and colleagues¹ and the accompanying Editorial by Dr Brennan² fail to note that in small hospitals where physicians wear many hats (peer review, credential committee, service chiefs), physicians must hide behind the curtain of confidentiality by either perjuring themselves or making credentialing a sham. As a member of a credentials committee, one is required to state that there is no knowledge of information that might have an adverse effect on the application. Since the board of trustees ultimately determines privileges based on recommendations of the credentials committee (whose decisions reflect administrative or peer review recommendations), withholding peer review information will reduce the reporting to the National Practitioner Data Bank (NPDB). This is particularly true when peer review involves retrospective evaluations over periods longer than 2 years. In such instances, a physician may be recredentialed twice without jeopardy and no reporting to the . . . [Full Text of this Article]

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RELATED ARTICLE

Hospital Peer Review and the National Practitioner Data Bank: Clinical Privileges Action Reports
Laura-Mae Baldwin, L. Gary Hart, Robert E. Oshel, Meredith A. Fordyce, Robin Cohen, and Roger A. Rosenblatt
JAMA. 1999;282(4):349-355.
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