Medical Peer Review is the process of evaluating individual professional performance by qualified peers as part of a system to maintain standards and improve performance within the profession. If misused, Peer Review can be a powerful weapon to constrain competitors, to eviscerate political rivals and to energize personal egos through the diminishment of other professionals. This is what is known as a Sham Peer Review.

In medicine, under the shelter of near absolute immunity provided by the HealthCare Quality Improvement Act of 1980 ("HCQIA") and state Peer Review counterparts, the system of review and accountability as enacted by the legislatures and reviewed by the courts assumes a high level of good faith and fair treatment of their colleagues by professionals. Like any system with a concentration of unaccountable power to destroy the professional reputation and livelihood of one's colleagues, there are bound to be abuses.