The AdvoKayte Podcast: Holding Healthcare Accountable!

Summary (48m 30s).
Episode 5: Anne Roberts - A Woman Who Watches the Guards

How do you know if a doctor or other medical practitioner is qualified to treat you? Who ensures that a specialist or a surgeon actually knows what they need to know to offer the virtual guarantees of patient safety our health care systems should offer? What are the red flags that accountability experts look for when vetting the medical practitioners we trust with our health and care.

It’s more complicated than the age-old question of who should guard the guards. In this episode of AdvoKAYte, we learn that it’s not about who does the guarding but more about how the guards should be guarded and the myriad of levels of processes necessary to do the job properly.

Anne Roberts has spent the last thirty years working to develop best practices in credentialing and peer review of doctors and other medical practitioners. She has consulted with organizations ranging from small rural hospitals to the largest health care systems in the nation. Though she tends to work on the side of the hospitals and large health care organizations that Kay seeks to hold to account, Anne sees a number of parallels between their work. 

“Kay: We are unlikely allies. You wear the dark hat and I wear the white hat.

Anne: Reaching out to you I knew that we might both be really small firecrackers but we were going to really be able to accomplish great things together. I knew we were going to be on the same page and we were both outraged. How could this happen and what can we do to prevent it from happening again in the future?

We’re both on the side of patient safety, so…”

So that starts an interview that delves deeply into the hows, what’s, wheres, and whys of the credentialing and peer review processes that underpin the mechanisms that promote patient safety in the United States. 

Anne talks about which levels are better at reporting, state boards or hospitals, and notes how the reporting databanks are geared to the wrong audience, and who they should actually try to educate and inform to get better results. 

Kay notes the business arrangements between doctors around surgical privileges and how Dr. A might recommend Dr. B from a financial point of view rather than solely based on patient needs.

“You have to turn over every rock”.

Anne describes the ongoing processes that make up the system used for credentialing medical practitioners. She identifies and talks about weak points in the system, how they’re exploited, and why some rogue medical practitioners might work together to cheat the vetting system. 

She talks about the investigative vetting process, how she’s learned to read between the lines to suss out suspicious candidates, what seemingly innocuous detail might be a serious red flag that starts a critical investigation uncovering previously undisclosed issues. 

Kay asks if doctor’s records should be available to medical consumers. Anne explains the privilege of privacy in peer review and why it is so necessary. She outlines how the peer review process offers protection to members of a medical team or to other practitioners when looking at the specifics of medical incidents, calling it an iron  curtain for malpractice attorneys because it allows physicians protection while they openly investigate medical incidents without that fear of retribution or fear of lawsuits and personal liability. 

There is a lot of pressure around credentialing and the peer review processes. This episode shows how the system is designed to protect patients. It also shows how the same systems can be undermined by the very people needed to ensure its credibility. Most importantly, this episode of AdvoKAYte shows how cooperation between people whose primary concerns revolve around patient safety can work together to expose problems in the systems and build better processes to vet, understand, and solve them.