Peer Review

The editorial “Peer Review Revisited” (Jan. 11) states that the California Assn. of Hospitals and Health Systems “ . . . Agrees that the effect of the new federal law could pose problems next October.”

CAHHS believes that existing California case and statutory laws on peer review are adequate. Based upon congressional intent and the federal statutes, CAHHS believes that the federal law will not cause problems in California. CAHHS concurs with Peter Budetti, M.D., counsel for the Health and Environment Subcommittee of the House Energy and Commerce Committee, chaired by Rep. Henry Waxman (D-Los Angeles), that: 1) the federal law is supplemental to (and not preemptive of) state laws and causes of action under state laws, 2) opting out of the federal law can occur at any time in the future (rather than before Oct. 14, 1989) and 3) the federal law supports, rather than supplants laws throughout the nation. Budetti advised CAHHS of the above positions on Jan. 12.

California’s immunity laws are better than the federal law. However, since the federal law does not preempt state laws, problems which were anticipated earlier will not materialize. Budetti pointed out that confidential information from other states may be restricted if California opts out of the federal law. Thus, the best interests of California would be served by not opting out.

CAHHS supports responsible peer review programs which have minimum governmental intervention and maximum local determination. Peer review is a process which is designed, first and foremost, to protect the public and ensure that the quality of care rendered to patients meets appropriate community standards.

I am confident that the best interests of patients are being served by present peer review activities in California. Our challenge is to preserve a good system and act prudently in considering changes.

C. DUANE DAUNER

President, CAHHS

Sacramento