Case Study: Physician Reviews Nurse Practitioner's
       Care

Situation:

• A medium sized physician group has hired a Nurse Practitioner to assist in a very busy pediatrics clinic
• One physician feels the care delivered is below the standard of care on several cases
• Peers of the physician are reluctant to voice opinion, but individually give support of the practitioner's care
• Physician with concerns refuses to discuss concerns with practitioner

QMCG Team Role: Assist the group's manager with an objective review and facilitate open discussion of concerns while enhancing lines of communications and work interactions:

• Objective peer review by a Board Certified Pediatrician with experience working with and monitoring physician extenders
• Advise in communication building techniques and team approach facilitation for group members
• Provide state law statute materials describing regulated relationship components to build a group policy on utilization of the specialized nursing team member to enhance practice efficiency

Peer Review Study Conclusions:

• Care by practitioner found to be at or above standard of care in every case reviewed
• Individual concerns by physician answered in writing
• Brain stormed during a conference call the approach options for presenting findings to group members
• Focused strategies on enhanced communication structure of physician and practitioner to increase efficiency, comfort and dignity of both members

Medical Staff/Clinic Accomplishments:

• Physician with concerns has voluntarily moved to different location of the practice
• Practitioner feels exonerated of criticism
• Entire staff more comfortable with how to best utilize the unique role of the practitioner to better the medical practice
• Win - win solution felt by all parties involved