Peer Review and All That

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Abstract
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. There are only a few nouns in the English language that have two directly opposite meanings. Such a one is "peer." As if that were not remarkable enough, the word also has a third meaning as a verb that has no etymological relationship to the other two meanings. The first definition is "Peer: one of superior rank or position, a nobleman, a holder of one of the five degrees of British nobility: Duke, Marquis, Earl, Viscount, or Baron." Its second meaning is more humble: "Peer: one of the same rank, an equal, a comrade." Will the peer review process of the Professional Standards Review Organizations (PSRO) bring together a group of comrades, reviewing records and clinical procedures out of mutual interest and concern for the welfare of the patient, as equals? If so, this new legislation will survive and might even go down in history as a triumph for self-regulation

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