Posted by mair on January 30, 2003, at 7:31:08
In reply to Article: Peer review for all therapy, posted by jane d on January 29, 2003, at 11:02:30
Jane I had read this article too and I thought it addressed these issues on a very superficial basis. She talks about the benefits, the principal one of which is that patients won't be so easily abused although her statistics indicate that the number of abusing shrinks is quite low. She really gives pretty short shrift to the privacy issue. Her contention is that the patient will feel better for knowing that someone else is reviewing his or her treatment and since it is peer review, confidentiality will not breached.
On the other hand, in her schema, it's not clear whether the patient knows who will be doing the peer reveiw. I live in a pretty self-contained area and know alot of therapists on a social basis. I'd be horrified to find out that one of them was reviewing my case. Even if my therapist didn't reveal the identity of her patient, there may be enough material in her notes to indicate who I was. (Although she did not start out this way, my therapist now takes pretty copious notes throughout our sessions)
Also, what happens when there's a disagreement among the peers? Who's really driving the course of my therapy? My therapist or peer reviewers? If a peer reviewer really questions what's going on, what is his or her recourse. Does he go directly to the patient? Does he go to the licensing board? Is a peer reviewer only going to see what the treating therapist wants him to see?
My conclusion is that what would happen is that a peer reviewer would only want to intervene in the most egregious of cases and that alot of privacy will be sacrificed to successfully flush out very few therapists.
Mair
PS: My guess is that many of the best therapists already seek a measure of peer review. I know my therapist is a part of a group which meets periodically to review one another's more difficult cases. I think this is different from the kind of "open door" the writer was considering, where a reviewer would have access to a patient's file.
poster:mair
thread:2323
URL: http://www.dr-bob.org/babble/psycho/20021230/msgs/2350.html