Radiologists want honesty, anonymity from peer reviews

A recent survey at a large academic hospital in Canada found that staff radiologists want feedback from their peers—but they prefer it anonymously.

Conducted by Michael Loreto, MD, of Health Sciences North in Ontario, and colleagues, the survey was published this month in the Journal of the American College of Radiology and investigated the attitudes and perceptions of staff radiologists regarding a new nonanonymous peer review system. 

Typically, errors discovered on previously reported studies were either discussed among the individual radiologists involved or brought up anonymously in the setting of departmental morbidity and mortality rounds.

Loreto and team found that although some individuals cite informal reviews of these acivities as being sufficient and doubt the need for a formal peer review system, this survey identified that approximately 1-in-5 radiologists do not routinely advise colleagues of errors.

“Traditional peer review processes have focused on individual physicians who either self-critique or critique their colleagues’ performance on an ad hoc, voluntary basis,” Loreto and colleagues wrote.

The authors conducted their survey via a questionnaire sent to all 39 staff radiologists at Sunnybrook Health Sciences Centre before the implementation of the PeerVue peer review system in the fall of 2012.

Thirty-six of the 39 surveys were completed. Of the survey participants, 86 percent agreed that peer review improves patient care and 81 percent agreed that peer review aids their own professional development. The vast majority of participants (92 percent) believed peer review should remain anonymous. Additionally, 67 percent of staff radiologists polled believe that nonanonymous peer reviews had the potential to damage interpersonal relationships within a department and 42 percent thought it could influence job security and rankings within a department.

A majority of the survey participants (81 percent) said they advise colleagues of errors routinely. Researchers found that in the group of radiologists who do not advise colleagues of errors, the majority had less than 10 years of experience—the more experience a radiologist had, the more comfortable he or she was found to be highlighting errors to less experienced colleagues.

In terms of potential legal proceedings, 76 percent of participants believed peer review would not be safe from malpractice issues.

“This survey demonstrates that the implementation of a formal peer review system in a radiology department is associated with both anxiety and uncertainty,” Loreto and colleagues wrote. “Although the intent of peer review is to be educational and enhance patient care, physicians remain concerned that peer review processes may be biased, potentially punitive, and open to medicolegal liability.”