Peer review works best for providers when the proceedings are confidential -- physicians and other staff can focus on a physician's performance, without concern for civil liability. However, even statutory privileges granted peer review proceedings aren't ironclad. Loopholes abound, and hospitals make mistakes that cost them the protection.

In the case of Dr. Lawrence Poliner, documents and evidence from his peer review proceedings were presented to the jury. The jury concluded that the hospital and physicians involved in suspending his clinical privileges acted in bad faith and with malice. The jury awarded him over $366 million in damages -- including $110 million in exemplary damages.

On March 27, 2006, the federal district court held Poliner could not receive double recovery for the same injury, which the jury had awarded-- and sent the matter to mediation for a determination of damages.

Listen as our authoritative panelists examine the steps that hospitals and their counsel can take to bolster peer review immunity and shield related documents from discovery -- and the implications and impact of the district court's most recent decision in the Poliner case.

Mark A. Kadzielski, Partner, Fulbright & Jaworski, Los Angeles, represents hospitals and health care providers throughout the U.S in a variety of matters, including peer review, government regulatory investigations, contracting issues, and credentialing.

Adrienne E. Marting, Partner, Powell Goldstein, Atlanta, concentrates in healthcare law and litigation. She represents hospitals, home health agencies, managed care entities, and other healthcare facilities and providers before administrative agencies and state and federal courts. She works closely with hospitals and their medical staffs on revising bylaws and related policies as well as peer review investigations and hearings.

The panelists address these and other key questions:

• Which parties and documents in the peer review process are privileged under HCQIA and relevant state peer review statutes?
• What factors have led courts to decide that peer review documents are discoverable and professionals involved are not entitled to immunity?
• What lessons can be learned from court decisions like Poliner?
• What are some typical weaknesses of peer review statutes that parties exploit when seeking access to information about proceedings?
• What can healthcare providers do to bolster their claim to peer review immunity?