There are many tools available to medical staffs in performing the central and critical functions of assuring quality of care and patient safety in the hospital. When it is necessary to review the care of a specific member of the medical staff, however, one profoundly important tool is probably underutilized by California medical staffs. That tool is “external” or “outside” review: sending records of care out for review by someone with appropriate expertise who is not a member of the medical staff. BothCMA and AMA policy support external peer review as an option for medical staffs. See CMA policy reprinted below, and AMA Policies H-375.960 (Protection Against External Peer Review Abuses) andD-375.996 (Peer Review Immunity).