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The first part of this article explored the flaws in the operation of peer review in two contexts: selection of articles for journal publication and decision-making in the award of research grants. There it was suggested that, to the extent these flaws had adverse effects on the information available to medical practitioners and those who conduct peer review of medical practice, the quest for improving the quality of health services is hampered. In this part of the article, medical peer review is defined, its practitioners noted, and the distinction between medical peer review and certain other activities and processes directed toward improving the quality of medical performance in hospitals illustrated.

Part I of this article explored flaws in the operation of peer review in the selection of articles for journal publication and decision-making in the award of research grants, and Part II described medical peer review, its practitioners, and the distinctions between medical peer review and other activities and processes aimed at improving the quality of medical performance in hospitals. This part of the article directs attention to how the courts respond when a physician, aggrieved by an adverse determination with regard to appointment, reappointment, or clinical privileges (credentialing) by the hospital based on medical peer review, seeks redress in the courts.

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This article discusses reasons for the failure of peer review in health care today, possible review options, and the effects of one option—compensation—on those common review problems.