Frequently Asked Questions

physicians reviewing electronic files

Physician Peer Review

  1. Why do physicians undergo a peer review?
  2. Is peer review confidential or anonymous?
  3. Who will be eligible for peer review?
  4. How often can I expect to be reviewed?
  5. How does the Physician Peer Review Nova Scotia program work?
  6. What are the guiding principles of the Physician Peer Review Nova Scotia program?



1. Why do physicians undergo a peer review?

We are directed to conduct peer review and practice assessment by the Nova Scotia Medical Act. Under section 64(1) of the Medical Act, the College Council is “… required to approve a practice assessment program with the objectives of:

a) Promoting a culture of continuous quality improvement; and
b) Enhancing the competence of individual members by linking their practice assessment to their professional development.”

Participation in the program for eligible physicians will be mandatory. The Act directs that members selected to participate in the program have a duty to comply.


2. Is peer review confidential or anonymous?

Other than under the very limited circumstances laid out in the Medical Act, the program will be confidential and fully protected from use for other purposes within the College (including complaints, investigations and licensing).


3. Who will be eligible for peer review?

The program will first be available to family physicians and will expand over time to include both medical and surgical specialties. For the time being, the Physician Peer Review Nova Scotia (PPR-NS) program will include only those physicians who have an active clinical component to their practice.  


4. How often can I expect to be reviewed?

Each eligible physician can expect to be reviewed at minimum, once every seven years.


5. How does the Physician Peer Review Nova Scotia program work?

Peer review involves an on-site practice visit that follows a standardized process using a selection of dedicated assessment tools, conducted by a trained peer. An alternate off-site review process will also be part of the program. Off-site reviews will include a review of patient records and an assessment of quality of care.  

The Physician Peer Review Nova Scotia (PPR-NS) program includes:

physician writing on chart
  • A concise, off-site review process for certain physicians. The accepted standard for peer review includes the conduct of an on-site review within a physician’s practice. The College has been working with other Canadian regulators to better understand the effects of both risk and protective factors on practice quality and physician well-being. Physicians whose practice profiles include factors known to promote quality in practice, may be initially directed to have an off-site review.
  • A reflective approach to continuing professional development activities has been developed. Physicians will be asked to consider their approach to professional development and challenged to adopt best practices for quality improvement in practice. This approach is aligned with a new Physician Practice Improvement (PPI) framework developed by the Federation of Medical Regulators of Canada.
  • Physicians completing a peer review process will receive a written report and be provided with one-on-one facilitated feedback from a trained peer.

6. What are the guiding principles of the Physician Peer Review Nova Scotia program?

College Council has directed that the Physician Peer Review Nova Scotia (PPR-NS) program reflect the following guiding principles:

  • Universality - all physicians can benefit from some form of peer review, recognizing that even the most capable physicians have identifiable opportunities for improvement;
  • Quality Improvement - the primary purpose of the peer review program will be to provide specific and meaningful feedback to each physician with the goal of helping them improve their practice;
  • Directive, when necessary - in limited circumstances, such as where safety concerns are indicated, the program will retain the authority to direct practice improvement;
  • The program is to be more heavily focussed on physicians more likely to benefit from peer review, with program resources allocated accordingly;
  • Fair, open and transparent - the processes, tools and standards employed by peer review will be well-communicated and consistently applied; and
  • Highly confidential, but not anonymous - information gathered during a physician’s peer review will not be disclosed to other areas of the College (e.g. Investigations or licensure) and will be carefully safeguarded by peer review staff. 

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