Policing Doctors

In the clubby and litigious world of medicine, doctors have been reluctant to finger incompetent colleagues. A high-court decision last week is likely to make them even shyer. The case, closely tracked by the medical community, involved Surgeon Timothy Patrick. In 1981 a peer-review panel was considering ending his privileges at the only hospital in Astoria, Ore., on the grounds of substandard patient care. Patrick resigned and sued the doctors in a rival practice, who had initiated and participated in the proceedings against him. His claim: conspiracy to eliminate a competitor. Though the law partly protects physicians who serve on peer-review panels from antitrust actions, the court ruled 8 to 0 that this protection did not apply here; it upheld a lower-court award of $2.2 million in damages to Dr. Patrick.

The decision prompted loud groans from the American Medical Association, which saw it as a threat to peer review. Though the A.M.A. admits the procedure may have gone awry in Patrick's case, it would have preferred a resolution at the state level rather than through federal antitrust laws. Antitrust damages are especially painful because they come out of a doctor's own pocket, notes A.M.A. General Counsel Kirk Johnson. "Antitrust is the atom bomb of lawsuits."