Dr. David Koronkiewicz, a retired orthopedic surgeon and current leader in healthcare quality, safety, and risk management, joins the podcast to discuss two major issues affecting physicians today: the peer review system and workplace violence in healthcare. Drawing from more than 30 years in clinical practice and extensive experience in administrative leadership, he offers a rare, multidimensional perspective on how internal hospital processes can deeply impact a physician’s career, finances, and long‑term wellbeing.
(Video Available January 7, 2026 at 6 AM Eastern)
Koronkiewicz explains how peer review—originally intended to ensure quality care—can be weaponized for political or competitive reasons. Sham peer review cases can lead to devastating outcomes including damaged reputations, loss of privileges, reporting to the National Practitioner Data Bank, and severe financial fallout. He highlights the importance of understanding hospital bylaws, due process, legal protections, and obtaining proper insurance coverage to safeguard against these risks.
The conversation then shifts to violence and bullying in healthcare environments. Koronkiewicz shares eye‑opening statistics about the rise in aggression toward healthcare workers, particularly post‑COVID. He emphasizes how hierarchical culture, burnout, sexual harassment, and lateral bullying all contribute to worsening morale, poorer patient outcomes, and increased turnover. He concludes by offering practical advice for early‑career physicians: stay informed, protect yourself, document everything, uphold professionalism, and never assume the system alone will keep you safe.
Key Takeaways:
- Peer review is a double‑edged sword, essential for quality assurance but vulnerable to misuse, with potentially career‑ending consequences.
- Workplace violence and bullying are escalating threats that drive burnout, turnover, and compromised patient care across healthcare systems.
- Physicians must prioritize self‑protection by understanding bylaws, documenting interactions, securing proper insurance, and maintaining professionalism in all environments.
Insights:
- Peer review can be abused for political, personal, or competitive motives, leading to sham reviews.
- The Healthcare Quality Improvement Act of 1986 provides immunity to reviewers but also created the National Practitioner Data Bank, making negative reports extremely damaging.
- Even minor behavioral interpretations (eye‑rolling, tone, body language) may trigger a “disruptive physician” label.
- Being labeled disruptive can result in remediation, suspension, or loss of employment.
- A suspension or investigation nearly always results in reporting to the Data Bank—regardless of whether a physician resigns.
- Hospitals sometimes weaponize the disruptive physician designation to silence dissent or avoid addressing systemic issues.
- Workplace violence and harassment have increased significantly, with more than 90% of emergency physicians reporting incidents.
- Burnout, absenteeism, turnover, and decreased safety are major financial and cultural consequences of workplace violence.
- Physicians should document all potentially concerning encounters with leadership and seek counsel early if issues arise.
- Professionalism and self-protection are not mutually exclusive—both are essential for career longevity.